Crohn’s disease is a type of inflammatory bowel disease (IBD) that causes chronic inflammation of the digestive tract. This inflammation can lead to symptoms such as abdominal pain, severe diarrhea, fatigue, and weight loss. Plasma donation, known as plasmapheresis, involves drawing blood, separating the plasma (the liquid portion containing proteins and antibodies), and returning the remaining components to the donor. The eligibility of a person with Crohn’s disease to donate plasma depends on a detailed assessment of their current health status and the medications they are using.
Determining Eligibility: The Conditional Answer
The simple answer to whether an individual with Crohn’s disease (CD) can donate plasma is that eligibility is conditional, not an automatic rejection. Donation centers must adhere to strict guidelines to ensure the safety of both the donor and the recipient. The primary consideration is that the donor must be in a state of good health, which is a complex determination for a chronic condition like CD.
A diagnosis of Crohn’s disease does not automatically lead to a permanent deferral, but it necessitates a thorough medical screening before each donation. This screening process focuses on the current activity level of the disease and the donor’s overall systemic health. The safety protocol is twofold, protecting the donor from potential complications during the procedure and safeguarding the plasma recipient from receiving compromised blood products. The presence of a chronic illness like IBD requires a more detailed evaluation than is typical for a healthy donor.
Disease Activity and Deferral Criteria
The most significant factor determining eligibility is the current status of the Crohn’s disease, specifically whether it is active or in remission. Active disease, characterized by current symptoms, recent flare-ups, or hospitalizations, results in a mandatory deferral from donation. This deferral protects the donor, who may already be experiencing fatigue or anemia, from the stress of the procedure.
Active inflammation also presents a risk to the recipient, as the inflammatory process in the gut can increase the presence of bacteria in the bloodstream. Bacteria could potentially multiply in the stored product, posing a severe risk to the recipient, who is often immunocompromised. For this reason, plasma donation is only considered when the CD is well-controlled and the donor is in a state of clinical remission.
Many donation centers require evidence of long-term remission, often meaning the donor has been asymptomatic for a specific period, such as six to twelve months. Even when symptoms are absent, the donor must meet other basic health criteria, including maintaining acceptable hemoglobin levels to ensure they are not anemic, a common complication of IBD. The deferral is lifted only when the treating physician confirms the disease is stable and the donor is in overall good health.
Medications That Prevent Plasma Donation
A second major factor leading to deferral is the use of certain medications prescribed to manage Crohn’s disease. The deferral is not always due to the medication itself but often because the drug’s presence in the donated plasma could be harmful to a recipient, especially one who is pregnant or has a compromised immune system. You should never stop a prescribed medication to donate plasma.
Immunosuppressive drugs and biologics are the most common cause of deferral for individuals with CD, often requiring a waiting period after the last dose. Biologics, such as TNF-alpha inhibitors like adalimumab (Humira) or infliximab (Remicade), are designed to alter the immune system and typically result in a mandatory deferral period, which can range from three to twelve months. Traces of these potent drugs in the plasma could affect the recipient’s immune response.
Conventional immunosuppressants, including azathioprine or methotrexate, can also lead to a deferral, though the required waiting time varies by drug and donation center policy. Conversely, some maintenance medications, such as 5-aminosalicylates (5-ASAs) like mesalamine, are generally not considered disqualifying, provided the donor is otherwise well-controlled and asymptomatic. Any individual seeking to donate plasma must be fully transparent about every medication they take to allow the center to make a proper, safe eligibility assessment.