Condition
An abnormality of cardiac electrical activity, most commonly diagnosed by electrocardiography.
Guidance at RECRUITMENT for adult volunteer donor and maternal donor (cord blood donation)
QUALIFIED, SEE BELOW
Guidance at CT/WORK-UP
QUALIFIED, SEE BELOW
Individual at Risk
Donor
Qualified Guidance
Where possible, particularly at CT-stage and work-up, advice from a cardiologist should be sought.
Acceptable
Benign atrial or ventricular ectopics (extrasystoles)
Sinus tachycardia/bradycardia acceptable, but inform anaesthetist at work-up if for bone marrow harvest.
Beta-blockers prescribed for benign ectopics or sinus tachycardia are acceptable.
Supraventricular tachycardias (SVT), including atrial fibrillation/flutter, may be acceptable if successfully treated with catheter ablation and off rate/rhythm-control medications (such as beta-blockers) for at least one year.
Right bundle branch block in the absence of any other abnormality
First degree heart may be acceptable at work-up at the discretion of the assessing physician.
Unacceptable
Uncorrected atrial fibrillation/flutter
Any history of ventricular tachycardia/fibrillation
Wolff-Parkinson-White/Lown-Ganong-Levine syndromes unacceptable unless treated with catheter ablation, and no ECG evidence of accessory pathways.
Second (Mobitz type 1, 2 or Wenkebach) or third degree heart block
All pacemakers and implantable cardiac defibrillators (ICD)
Left bundle branch block
Long-QT syndrome, Brugada syndrome or any other known cause of sudden cardiac death
References
Halter J, Kodera Y, Ispizua AU, Greinix HT, Schmitz N, Favre G et al. Severe events in donors after allogeneic hematopoietic stem cell donation. Haematologica 2009; 94(1): 94-101.
Komatsu F, Shikata M. Abnormal electrocardiographic findings in apheresis donors. Transfusion 1988; 28(4): 371-4.
Laspina SJ, Browne MA, McSweeney EN, Lawlor J, Whelan DM, Kinsella AL et al. QTc prolongation in apheresis platelet donors. Transfusion 2002; 42(7): 899-903.
Povsic TJ, Losordo DW, Story K, Junge CE, Schatz RA, Harrington RA et al. Incidence and clinical significance of cardiac biomarker elevation during stem cell mobilization, apheresis, and intramyocardial delivery: an analysis from ACT34-CMI. Am Heart J 2012; 164(5): 689-697 e3.
Yuan S, Ziman A, Smeltzer B, Lu Q, Goldfinger D. Moderate and severe adverse events associated with apheresis donations: incidences and risk factors. Transfusion 2010; 50(2): 478-86.
Notes
One member of the review committee the acceptability of donors with a history of supraventricular tachycardia treated with catheter ablation and off rate-control medication for one year.