(Contra) Indications - Bone Marrow Transplant

The process of becoming a Bone Marrow Donor is very simple through the Anthony Nolan Trust
1) You need to make sure you meet the following General Criteria:
- age 18 - 40 : health and circumstances permitting, you remain on the Register until your 60th birthday, so don't be put off joining if you are close to 40
- in general good health
- weight over 51kg / 8 stone
- women must not be pregnant
- women with children under the age of 12 months cannot join the register or donate marrow during that time
In addition you will need to check that you not excluded through the Medical Criteria (set out below)
Although it costs up to £70 to recruit each donor, tissue-type each sample, and maintain the donor's records there is no cost or charge for you and you can ‘sign up’ from anywhere in United Kingdom, so long as you are a UK resident.
2) Completing the Paperwork
You can obtain an information pack and medical questionnaire in four ways:
- calling Anthony Nolan hotline number - 0901 88 22 234 : calls are charged at 25p per minute and a proportion of the call charge comes to the Trust
- writing to: The Anthony Nolan Trust, Units 2 - 3, Heathgate Place, 75 - 87 Agincourt Road, London, NW3 2NU
- attending a donor recruitment clinic near you
- email: newdonor@anthonynolan.org.uk
3) Giving a Blood Sample
A blood testing kit can be sent to you by the Anthony Nolan Trust, so that you can take this to your local GP or health clinic, where a small sample of your blood will be taken - about 4ml. Needless to say, on no account should you attempt to take the sample yourself.
The sample will be forwarded to the Anthony Nolan laboratories, where it is tested to establish your tissue type. The results are stored on their database, which is, of course, confidential.
As a new member of the Register you will receive confirmation of your status as a potential life saver.
You may be found to be a match for a patient almost immediately; other people wait many years before being asked to donate - and some never are.
Every single person on our Register is still making a wonderful commitment – to make themselves available to support another person in need of a life saving transplant.

Find out more at www.anthonynolan.com

Medical Criteria
For a variety of reasons which can relate to the outcome of a transplant, or to your own welfare as a donor, certain conditions prevent you from joining the Register.
The application you complete before giving a blood sample covers all of the following medical conditions.

ALCOHOL
Sometimes Acceptable
No - if you are alcoholic or regularly consumer more than 40 units a week as a man or 30 units a week as a woman; or if you are on antabuse.
Exception - if you have recovered from alcoholism, and it has been two years or longer since recovery

ALLERGY : drug-induced
Generally Not Acceptable
Exception - if environmentally produced

ANAEMIA
Generally Acceptable
No - especially if there is a history of persistent anaemia or if someone is regularly anaemic i.e. more than three times a year.
Exception - you are only temporarily or rarely anaemic, you are not taking medication and you haemoglobin count is within the accepted range

ANKYLOSING SPONDYLITIS
Definitely not acceptable

ANGINA
Definitely not acceptable

ASTHMA
Generally not acceptable
No - if you are on continuous high dose medication (more than 8 inhalations /puffs per day) as people suffering from asthma are more likely to have post-operative complications.
Exception - if medication is taken rarely, less than 8 inhalations/puffs per day or if the asthma is brought on by an allergy

BACK PROBLEMS
Generally Not Acceptable
No - if upper back / neck problems, chronic lumbar vertebrae problems, such as slipped discs or sciatica, chronic lower back problems, or any injury which means that you are have to avoid certain sports, heavy lifting, prolonged seating
Exception - minor muscular problems or minor problems in the cervical or thoracic areas of the spine

BRAIN SURGERY
Generally Not Acceptable
Exception - if the brain surgery was performed after September 1992

CANCER
Definitely Not Acceptable
No - if any form of cancer including skin cancer even if you have been given the all clear by your treating physician.

CHRISTMAS DISEASE
Definitely Not Acceptable

CIRRHOSIS
Definitely Not Acceptable
No - there is a risk with general anaesthetic and bleeding.

COAGULATION DISORDERS
Definitely Not Acceptable
No - if you have a history of DVT, PE, Leiden factor, Von Willebrands.

CELIAC DISEASE
Definitely Not Acceptable
No - intolerance to gluten may relate to the auto-immune system

CROHN'S DISEASE
Definitely Not Acceptable
No - auto-immune

CYSTIC FIBROSIS
Definitely Not Acceptable
No - medical risks associated with general anaesthetic

DEPRESSION
Generally Acceptable
No - if endogenous, manic or severe.
Acceptance criteria - mild, short-term reactive depression with short term medication
N.B. individual assessment is obligatory

DIABETES
Generally Not Acceptable
No - insulin or tablet dependent diabetes can be associated with auto-immune disease which could be passed on to the patient.
Exception - non insulin-dependent diabetes, well controlled by diet

DERMATITIS HERPETIFORMIS
Definitely Not Acceptable
No - as often associated with coeliac disease.

DOWNS SYNDROME
Definitely Not Acceptable

ECZEMA
Generally Acceptable
No - if atopic (since childhood and severe) or if auto-immune related
Exception - mild and irregular

ENDOMETRIOSIS
Generally Acceptable
Acceptance Criteria - if well controlled.

EPILEPSY
Generally Not Acceptable
No - if on medication, due to risks associated with general anaesthetic
Exception - if you have not had a seizure for a minimum of 3 years and have not taken medication during that time. Donors must be aware that there is a small risk of fitting when awakening from the anaesthetic but this can be well-controlled

GALL STONES
Generally Not Acceptable
Exception - If you have undergone surgery and have no current problems.

GASTRO-INTESTINAL SYMPTOMS such as ulcers, general gastritis
Generally Acceptable
Exception - If the condition is well-controlled, with no internal bleeding or other complications.

GLANDULAR FEVER
Generally Acceptable
No - if a current condition or if you are still suffering from after effects
Acceptance criteria - if in the past and mild.

GRAVES DISEASE
Definitely Not Acceptable
No - auto-immune

HEART CONDITIONS
Generally Not Acceptable
No - angina, cardiomegeneral anaestheticity, cardiomyopathy, past history of heart attacks, heart arrhythmia, pacemaker, or a congenital condition such as thickened valve, hole in heart, heart murmur or any other condition which requires individuals to take antibiotic cover at any time, as all are considered a risk under general anaesthesia
Exception - if you have a congenital heart condition but do not have to take any prophylactic antibiotic cover at any time and are in good health

HEPATITIS A
Generally Acceptable
Acceptance criteria - if you have been clear for longer than 12 months and you are currently asymptomatic.

HEPATITIS B OR C
Definitely Not Acceptable
No - these viruses are found in body fluids, including blood and bone marrow.

HIGH BLOOD PRESSURE
Generally Not Acceptable
Exception - if the condition is well-controlled by medication and the most recent blood pressure reading is below: 150/95

HIP REPLACEMENT
Generally Acceptable
Acceptance Criteria - as long as no current problems at all but you must be aware that some short-term back pain could arise if you donate

HIV EXPOSURE
Definitely Not Acceptable
No - if you have been knowingly exposed to HIV you are considered a high risk category

HUMAN PITUITARY EXTRACT TREATMENT
Generally Not Acceptable
No - if treated with growth hormones or gonadotrophins
Exception - if treatment started after 1987

HYPOTHYROIDISM (MYXOEDEMA)
Generally Not Acceptable
Exception - if the cause is not auto-immune related

HYSTERECTOMY
Generally Acceptable
Acceptance Criteria - if the operation was over 6 months ago and there were no malignancies

ITP
Definately Not Acceptable
No - auto-immune

JAUNDICE
Generally Not Acceptable
Exception - the jaundiced was experienced as a baby or at a young age.

LUPUS (SLE)
Definitely Not Acceptable
No - auto-immune

MAJOR SURGERY OR OPERATION
Generally Not Acceptable
Exception - if at least six months must have elapsed since the operation and you are clear of all post operative symptoms.

MALARIA
Generally Not Acceptable
No - especially if within the last 12 months
Exception - if you have taken a full course of anti-malarial tablets, the timespan was longer than 12 months ago, and no symptoms are being experienced

ME / POST VIRAL SYNDROME
Generally Acceptable
Acceptance Criteria - only one episode over 12 months ago and no relapses have occurred

MIGRAINE
Generally Acceptable
Acceptance Criteria - if mild or infrequent (less than every 2 months

MS
Definitely Not Acceptable
No - auto-immune

MYASTHENIA GRAVIS
Not Acceptable
No - Autoimmune

OCD (OBSESSIVE COMPULSIVE DISORDER)
Generally Not Acceptable
No - especially if severe
Exception - depends on severity/ treatment - individual assessment necessary

OSTEO-ARTHRITIS
Generally Acceptable
No - especially if severe
Acceptance Criteria - if the treatment is mild, you are not on steroids and the hip and spine areas are unaffected

OSTEOGENESIS IMPERFECTA
Definitely Not Acceptable
No - there is a risk of fracture

OSTEOPOROSIS
Definitely Not Acceptable
No - a risk of bone damage

PANCREATITIS
Generally Not Acceptable
No - especially if chronic and with diarrhoea.
Exception - if there has been just one episode and you are fully recovered

PARAPLEGIC / TETRAPLEGIC
Not Acceptable

PERICARDITIS
Generally Not Acceptable
Exception - if fully recovered and no antibiotic cover needed

PERNICIOUS ANAEMIA
Definitely Not Acceptable
No - auto-immune

PITUITARY TUMOUR
Generally Not Acceptable
Exception - if benign, with no post-operative complications

PLEURISY
Generally Not Acceptable
Exception - if just a single incident with no recurrence

POLIO
Generally Not Acceptable
No - with serious physical disabilities which could be aggravated by donating marrow
Exception - if mild and no serious physical disabilities

POLYCYSTIC KIDNEY
Not Acceptable

PRE-CANCEROUS CELLS
Generally Not Acceptable
Exception - if your last two smear tests have been clear

PREGNANCY
Generally Not Acceptable
Exception - you can only join after your baby is 12 months old

PROCTITIS
Generally Not Acceptable
No - If autoimmune

PSORIASIS
Generally Not Acceptable
Exception - if very mild

PSORIATIC ARTHRITIS
Definitely Not Acceptable
No - auto-immune

PULMONARY EMBOLISM
Definitely Not Acceptable

PUPURA
Definitely Not Acceptable
No - could be auto-immune

RAYNAUD'S SYNDROME
Generally Not Acceptable
No - if associated with SLE

ROSACEA
Generally Not Acceptable
Exception - if localised, e.g. on the face.

RHEUMATIC FEVER
Definitely Not Acceptable

RHEUMATOID ARTHRITIS
Definitely Not Acceptable
No - auto-immune disease

SARCOIDOSIS
Definitely Not Acceptable
No - the cause is unknown, can affect any system, heart, lungs bone

SCIATICA
Generally Not Acceptable
Exception - the condition is mild and does not interfere with your normal lifestyle

SCHEUERMANNS DISEASE
Generally Not Acceptable
Exception - no current problems

SCHIZOPHRENIA
Definitely Not Acceptable
No - medication given is usually a contra-indication to general anaesthetic

SCOLIOSIS
Generally Not Acceptable
Exception - if you have no current back problems or rods inserted

SICKLE CELL DISEASE
Generally Not Acceptable
Exception - as trait only

SLEEP APNOEA
Definitely Not Acceptable
No - there is a risk with airway post general anaesthetic

SLE
See Lupus

SPINA BIFIDA OCCULTA
Generally Not Acceptable
Exception - if you are free from problems or mobility problems

TACHYCARDIA
Generally Not Acceptable
Exception - if mild and you are not on medication

TATTOOS / BODY PIERCING (Recent)
Generally Not Acceptable
Exception - if 12 months since tattoo or piercing

TAY SACHS DISEASE
Generally Not Acceptable
Exception - as trait only

TESTOSTERONE INJECTIONS
Generally Not Acceptable
Exception - synthetic injection

THALASSAEMIA
Generally Not Acceptable
Exception - as trait only

THROMBOCYTOPENIA
Definitely Not Acceptable

THYROID
Generally Acceptable
No - if you have Graves disease or Hashimoto's disease, due to auto-immune association
Acceptance Criteria - if you are on thyroxine. If you are on other drugs individual assessment is necessary

TB
Generally Not Acceptable
Exception - if you have been clear for more than 24 months and are not on medication

TURNERS SYNDROME
Generally Not Acceptable
Exception - if the donor has no heart problems

ULCERATIVE COLITIS
Definitely Not Acceptable
No - auto-immune.

URTICARIA
Generally Not Acceptable
Exception - if the condition is mild. Individual assessment is necessary

VITILIGO
Definitely Not Acceptable
No - can be associated with auto-immune disorders.

The following medical conditions do not preclude donating, but should be noted on your registration to join our bone marrow register :
- Gilberts' syndrome
- Hormone replacement therapy
- Irritable bowel syndrome
- PID (Pelvic Inflammatory Disease)
- peritonitis
- polycystic ovary
- renal colic (kidney stone)
- shingles
- termination of pregnancy
- Toxoplasmosis