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
Where possible, particularly at CT-stage and work-up, advice from a cardiologist should be sought.
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.
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
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.
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.