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JimL
November 16th, 2002, 08:54 AM
I have enjoyed donating blood for decades. I finished donating my sixth gallon in Michigan about two months before heart surgery, in addition to what I donated in Illinois and Wisconsin previously. While in college a bunch of us would walk down together and donate, kid the nurses, enjoy the free food (which was better than the cafeteria), and walk back to school together. When I have donated blood in the past, I've always felt like I was young again, sharing that college experience.
Now that I'm on coumadin forever, I'm told that Red Cross doesn't want my blood. I haven't yet pursued that question to the end with them. Probably they don't want my blood because they can't use blood that won't clot quickly on someone who's losing blood rapidly. But there is still doubt in my mind. Perhaps they don't want my blood because they're afraid that I won't stop bleeding after I donate. Does anyone know for sure? Is it that they don't want my blood, or is it that they're ignorant about coumadin?
We have our next local blood drive a month from tomorrow, I hope to have the time to go down anyway, but I hesitate to take up a Red Cross nurse's time with my question.

Nancy
November 16th, 2002, 09:40 AM
As far as I know, you cannot give blood while on Coumadin. I know that Joe can't.

Creed3
November 16th, 2002, 12:07 PM
I don't know the answer to that question. I used to donate blood as well and was told flat out that I could not donate blood anymore. I was not given a reason as to why, I just assumed it was because of being on coumadin and I never questioned them further on it. If you find an answer, let me know.

Take Care!
Gail

Hank
November 16th, 2002, 03:25 PM
I know how you feel Jim - I used to donate regularly and now cannot. The only way we coumadin folks will ever be able to donate blood is to lie on the little interview because they will NEVER let coumadin taking folks give blood. So, what this means is that we must watch from afar while others get the blessings for helping out with blood donations. We are just gonna have to donate something else I guess. Maybe time, money, or a kidney or something ;)

LUVMyBirman
November 16th, 2002, 07:29 PM
I may be having surgery in the near future, 'non heart related'. My internist urged me to consider banking away a minimum of three pints. Even on the Coumadin..... they informed me I can do what is called a directed donation to myself. This really surprised me. Coumarians cannot donate to the general public. When and if I get to the point of carrying such out....I will post my findings.

I had cardiac clearance to donate to myself prior to me MVR.. Other than the valve, my heart function is perfect. Guess it depends on the condition of your heart if they will allow you to donate at all.

allodwick
November 17th, 2002, 07:42 AM
I have had several people do what Gina is planning, donating blood ahead of time for their own surgery. The local blood bank wants the INR to be below 2.0 before they will accept it. One time the INR was 2.1 and they called the pathologist who accepted it.

As far as I know, they will not accept a general donation from someone on warfarin.

MarkU
November 21st, 2002, 04:00 PM
Interesting. My local Red Cross blood bank told me I could donate blood as long as I have written permission from my cardiologist. They told me that the Coumadin wasn't a problem. Anybody have any actual solid scientific info?

Mark

McCln
November 28th, 2002, 01:53 AM
Weren't you listening, it is medically impossible to donated blood that does not clot properly. You do not need to be a rocket scientist to know this informtion from the sources is correct. We all would love to donate blood as much as we want to, but as long as the blood can't clot properly, we can't donate. Coumadin and ecotrin is the culprit because our blood is thinner now also. You all take care.

Caroline
09-13-01
Aortic valve replacement
St. Jude's valve

MarkU
November 28th, 2002, 06:45 AM
Caroline,
I was stating a fact. The Red Cross here in Sarasota told me that I could donate blood with my doctor's permission and if I told them that I was on Coumadin at the time I donated.
I was asking if anybody had any hard, factual scientific reference to confirm or deny that this was accurate.

I certainly do not appreciate the sarcastic tone of your reply.

Mark

Nancy
November 28th, 2002, 07:16 AM
Take a look at this link re: donating blood.

http://www.redcross.org/services/biomed/blood/learn/eligibl.html#medications

MarkU
November 28th, 2002, 07:29 AM
Thanks for the link Nancy. I'm going to ask the local blood bank about it. Like I said earlier, they didn' t have any problem with me donating, nor did my doctor. Of course, maybe somebody down the line threw it away.
At least I got some free orange juice and a cookie...

Mark

MarkU
November 28th, 2002, 08:37 AM
Yikes! I spent about three months a year in England, Holland and Germany on business for about five years prior to my surgery.
They probably take my blood straight the toxic waste dump with all the used motor oil and anti-freeze!

Mark

:(

JimL
November 28th, 2002, 01:08 PM
Nancy, thanks much for the link which says, "Coumadin, heparin or other prescription blood thinners- you should not donate since your blood will not clot normally. If your doctor discontinues your treatment with blood thinners, wait 5 days before returning to donate."
However, my question still remains: Is this because they don't want me to bleed to death
OR
Because they won't give my blood to anyone?
The answer on the link still seems ambiguous. However, if Red Cross clearly says they don't want my blood, I suppose that settles it, even if I don't know why.

Nancy
November 28th, 2002, 01:46 PM
Jim-

From what Joe has said re: blood donations (he's been on Coumadin for 25 years), they can't use any blood with anticoagulation in it because it would pose a danger for the person receiving it. Coumadin, if stopped, would clear the body in a few days, so I guess that's why the 5 day waiting period after discontinuation of Coumadin and the other anticoagulants.

If it were you bleeding to death, all you Coumadiners would do that every time you went to the lab.

When Joe had his total bleedout after his gallbladder surgery, he needed 30 units of blood products to stop the bleed. Imagine if any of that had anticoagulation in it. He'd be gone.

But ask your blood center, maybe they have another way of looking at it.

Gisele
December 7th, 2002, 04:18 PM
About 8-10 years ago (on coumadin now for 20+ years), and prior to surgery my gyn had me go in and donate to myself. Now that poses the question, if they had the need to use it, it wouldn't it be anitcoagulated? I was admitted prior to surgery and put on heparin. Therefore, is there some type of filtering they can do with the blood to remove the anticoagulants??? Do they just take the platelets??? I am not really sure what they did to my blood. I guess I should have asked.

Gisele

allodwick
December 16th, 2002, 05:16 AM
No filtering will remove the anticoagulants. What you might have done was held the warfarin a day or two to get your INR below 2.0.

TheGymGuy
December 21st, 2012, 06:52 PM
Bumping this up, as I was going to get swabbed for possible donation for a hodgkins cancer patient. Still going to go get swabbed to see if the type matches as we are not related, but if it does I wonder if I could donate. Lots of great info here.

ski girl
December 22nd, 2012, 03:59 AM
Yeah it's the concern about blood that doesn't clot as fast as 'normal' blood going to someone else and the uncertainties that would cause in their treatment.

On a different note, I tried to sign up to be a bone marrow donor (warfarin shouldn't affect that!) and was told no due to the impact the operation would have on me. I said that was really my concern, if I had to come off warfarin for a couple days just like I would if I had to have any other operation, that would be more than worth it to potentially save someone's life.

Still, no. THAT I don't understand.

TheGymGuy
December 22nd, 2012, 05:27 AM
@Ski Girl, that really sucks. I suppose we could go off warfarin for 2 days, donate, and go back on. In theory once our INR is under 1.5 we could donate no problem.

tom in MO
December 22nd, 2012, 05:04 PM
Although many people safely go off warfarin for necessary procedures, some do have stokes. This happened to my mil. The stroke was "minor" but being 85yo she never fully recovered. She was bridged at a well respected heart hospital in Milwaukee, "stuff happens"

LucyLou
December 23rd, 2012, 05:40 PM
This is an interesting thread, my questions are how can we be donors after death? I had always thought about donating my organs, scratch the heart, no one could use it, but I have other healthy organs that give the gift of life. I am asking my cardio about this at my February appointment!

TheGymGuy
December 23rd, 2012, 06:36 PM
LucyLou, a very interesting point. I am a donor on my driver's license as well, I am curious what your cardio says.

dtread
December 24th, 2012, 05:35 PM
I donated through American Red Cross and National Institute of Health (NIH) Blood Banks for years before going on Warfarin. I also donated through American Red Cross Research Donor program, where the blood is used for research and the requirements for donation are not as stringent. From my inquiries post op it appears that none of these are interested in your blood as long as you're on Warfarin. I also inquired with the Armed Services Blood Program as they had a blood drive where I work, and they are also not interested as long as you're on Warfarin. What I have been told is that you have to be off Warfarin for 30 days before they'll take your blood.

triff
January 2nd, 2013, 09:22 AM
I registered as a bone marrow donor around 18 months ago and had to remove myself from that and the blood donor register after my MMVR in June '12.

I'm hopeful, being young and generally fit and healthy, that at some point in the future maybe medications or criteria will change and I'll be able to donate. It's extremely frustrating that the same life event that underlined mortality and made me more determined to help others is the exact same reason I can no longer do that.

Protimenow
January 2nd, 2013, 01:54 PM
The issue, as I understand it, is not that you will bleed out when you are giving blood, but that there may be management problems with the blood recipient. (For example, consider a patient with impaired liver function who normally has a high INR; or a patient who received heparin during surgery -- adding blood with a high INR/residual warfarin could cause an uncontrollable bleed. The risk of using blood from a person who is receiving warfarin may be too high to administer to patients requiring donated blood).

If you want to give to help people (and blood is one of the things that should be fairly easy to donate - if we could), perhaps you can give some volunteer time at a clinic or shelter, where your time will do a lot of good?

dtread
January 3rd, 2013, 05:32 PM
According to info I found on the Internet, the average male has about 10 - 12 pints of blood and the average female about 8 - 10 pints of blood. So, even if somebody was transfused with a pint of blood that was at a high level of anticoagulation (e.g., 3.5 INR or higher) it would still only account for roughly 8% - 12% of their blood supply. Unless whoever received the transfusion was also on Coumadin, the infusion of one pint of anticoagulated blood should not affect their INR level hardly at all. I think most of the objection to accepting Coumadin patients as blood donors is simply based on long-standing historical misconceptions about Coumadin. When the drug first came out over 50 years ago it was probably put on the deferral list of drugs for the Red Cross and other Blood Banks, and subsequently no one has ever really thought about whether it makes sense or not.

RobThatsMe
January 4th, 2013, 04:47 AM
The issue, as I understand it, is not that you will bleed out when you are giving blood, but that there may be management problems with the blood recipient. (For example, consider a patient with impaired liver function who normally has a high INR; or a patient who received heparin during surgery -- adding blood with a high INR/residual warfarin could cause an uncontrollable bleed. The risk of using blood from a person who is receiving warfarin may be too high to administer to patients requiring donated blood).

If you want to give to help people (and blood is one of the things that should be fairly easy to donate - if we could), perhaps you can give some volunteer time at a clinic or shelter, where your time will do a lot of good?

I totally agree with you P-time.

I can understand why folks who always donated would like to continue doing so, BUT, that could be deadly to the recipient, and selfish of the donor, just to feel good about helping others in need. Life changing events happen to us all, so if someone who used to donate, but due to warfarin, can no longer, then find another way to "feel good about helping out". Think of it this way, if you had a family member, that was facing surgery, or was in an auto accident, would you want blood that could not clot, or clotted at a reduced rate given to them?

Rob

Protimenow
January 4th, 2013, 11:10 AM
Dtread -- you make an interesting point, but in a lot of trauma cases - and for some surgeries - the patient may receive many units of blood. Although they won't come from just one person, if enough of us on anticoagulants gave blood, it's possible that there may be enough anticoagulated blood used that a real problem can occur. Also, even if 8-10% of a patient's blood is replaced with anticoagulated blood, this may cause a management problem. (If a patient is not adequately clotting, how do you assess the effects from a patient's own system, versus those from donated blood?). Also - during surgery, they can also test the blood for prothrombin time, as well as many other factors -- if the prothrombin time of a patient is elevated, can treating it as if the PATIENT's INR is high because of liver problems bring the patient's INR TOO LOW?

I think that, with the possible wrong signals that anticoagulated blood inserted into the donor supply can create, that the Red Cross (and others) have wisely decided NOT to use such blood. (OTOH -- if I was planning to have surgery, I may bank my OWN anticoagulated blood in case I needed a transfusion -- it will at least be a known quantity and may actually make it easier for the doctors to manage my INR).

dtread
January 4th, 2013, 11:48 AM
As long as there are enough blood donors to keep supplies at adequate levels they're not going to allow folks on Coumadin to donate. Why should they? If there was a severe shortage of blood, or if the (potential) donor that was on Coumadin had a really rare blood type they might change their tune. I personally would not have any qualms about donating for any of my family members (none are on Coumadin), but the blood bank and the doctors probably wouldn't allow it, so its a moot point. One thing that hasn't been mentioned much in this discussion so far is possible interaction between Coumadin and some other drug(s) that the recipient might be on. That is another point to be considered. Lastly, one thing that could be done if they were to allow Coumadin donors to donate blood would be to note that right on the blood bag. That way the concerns that were expressed previously in this thread that someone might get several pints of anticoagulated blood could be avoided.

Protimenow
January 4th, 2013, 01:39 PM
Right.

If your blood type was extremely hard to match (perhaps it had some factors that only others in your close family could use), donating your blood shouldn't be a problem -- but THEN the medical team would be aware of the donor and of the anticoagulant in the blood.

Your suggestion about marking bags of blood from anticoagulated patients makes sense -- perhaps even marking the INR of the collected blood would make it possible for the blood to be used. Good idea.

RobThatsMe
January 4th, 2013, 06:13 PM
As long as there are enough blood donors to keep supplies at adequate levels they're not going to allow folks on Coumadin to donate. Why should they? If there was a severe shortage of blood, or if the (potential) donor that was on Coumadin had a really rare blood type they might change their tune. I personally would not have any qualms about donating for any of my family members (none are on Coumadin), but the blood bank and the doctors probably wouldn't allow it, so its a moot point. One thing that hasn't been mentioned much in this discussion so far is possible interaction between Coumadin and some other drug(s) that the recipient might be on. That is another point to be considered. Lastly, one thing that could be done if they were to allow Coumadin donors to donate blood would be to note that right on the blood bag. That way the concerns that were expressed previously in this thread that someone might get several pints of anticoagulated blood could be avoided.

I would be leary of that. Each person that would donate blood while on Coumadin would have different INR levels!
Can you imagine trying to regulate and stablize that mix!

ElectLive
January 4th, 2013, 09:40 PM
There is a very very long list of Red Cross eligibility criteria, with more than a few disputably arcane rules. But rules are rules all the same. I'm a tissue valver, not on Coumadin, but I'm ineligible. Why? I used animal sourced insulin as a kid many many years ago. Any use after 1980 is deemed a potential threat due to concerns of Mad Cow / CJD. Now, technically I could get a waver if I could prove the cows used for my insulin weren't from the UK...but hmm...as much as I love research, that's just a bit too much of an undertaking for my taste.

But should otherwise be ok, right? Nope, folks with pacemakers have stipulations too. Your pulse must be between 50 and 100 with only a "small" number of irregular beats. Now, as the first rule disqualifies me, I haven't taken the steps to inquire for more specifics on this one, what constitutes "small" etc. Then, as if that weren't enough, what else... Oh yeah, aspirin. Have to withhold 2 days when donating platelets, ok by the rules for whole blood but have heard of holds for that too.

Anyway, I don't mean to steer this discussion too far of course, just wanted to point out that there are actually quite a few rules and restrictions on blood donation, and I'm sure a number of frustrated folks out there with and without mechanical valves. So a big +1 to the point above about "donating" in other ways if we must...

Protimenow
January 5th, 2013, 08:18 AM
There's a problem with all these rules -- and with documents, in general: People Don't Read.

I suspect that, if there's a multipage questionnaire that must be filled out before donating blood, many (most?) people will skip the boxes (or just absent-mindedly check them off), and proceed to the end, where they may have to sign the thing. Their goal is to get through the paperwork, and get the needle in their arms. Plus, I suspect that the questions may be confusing -- if they're asked 'do you take coumadin?' they may answer NO because they weren't asked if they take Warfarin. If they're asked 'do you take an anticoagulant' they may answer no because they take a 'blood thinner.'

For some obscure reason, I read everything that I sign -- and I often find mistakes in forms that have been in use for years (decades?) and nobody apparently caught before. (Perhaps it's the result of an undetected TIA that rewired my brain to actually READ and try to UNDERSTAND everything before I sign it)

My point isn't that there's a lot of crummy writing out there - and people are conditioned to sign things without reading them first -- it's that, with a lot of rules for qualifying or disqualifying donated blood, I wouldn't be surprised if a lot of blood that SHOULDN'T have been donated is always in the pipeline. (To help allay concerns about the safety of our blood supply, I'm sure that tests are run on it - either at the time of donation or while it's being processed - to detect a lot of things (like, for example, INR, HEP-C, and other stuff)

metronome
January 10th, 2013, 05:50 PM
What I find intriguing is no blood components are acceptable. I understand they don't want our platelets, perhaps even red cells. But what about plasma ? Do we have any hematologists on board....

ski girl
January 10th, 2013, 06:32 PM
I think I might have a chat with our bone marrow registry again and this time not tell them that I'm on warfarin. ;)

Protimenow
January 10th, 2013, 08:25 PM
Perhaps they don't actually know where the warfarin is actually producing the anticoagulant effect -- it may not be with the platelets; it may perhaps in the serum, which is in intimate contact with the platelets, thrombin, and other blood components. Perhaps they don't know if ANY of the components would have an adverse impact on the clotting capacity of the blood recipient. Because everything in contact with the blood is probably awash with warfarin or secondary metabolites, I suspect that they may not feel safe using ANY of it.