NATIONAL

111I02502

GUIDELINES FOR THERAPEUTIC VENESECTION

REFERRAL POLICY

All patients are to be referred by a physician or general practitioner using the NZBS Referral form.
The form is to be sent to the local NZBS Collection Centre. Information on the referral form must
include a complete description of the health of the patient, age, other medical conditions,
medication history, allergies and cardiovascular-respiratory health.

If the patient is medically unfit for venesection in a community setting as set out in Section 2 then
he/she is referred to the local physician responsible for haemochromatosis at the DHB who will
arrange for venesection to occur.

1. GUIDELINES FOR VENESECTION AT AN NZBS DONOR CENTRE

• Donor centre staff will follow regional NZ Blood Service Standard Operating Procedures for
the management of haemochromatosis, including maintenance treatment and any
transition to donor status.

• All patients must have a confirmed clinical diagnosis or clinical issue that requires
venesection. In the case of haemochromatosis each patient must satisfy the diagnosis
with relevant genotype or elevated ferritin and raised iron saturation.

• Patients must meet a minimum standard of cardiovascular and respiratory health before
acceptance for venesection at NZBS Collection Centres as medical oversight is not
immediately available at some donor centres.

• Patients will be advised to drink fluids and eat well prior to each procedure.

• Patients must be aged between 16 and 75 years old.

• Patients who have clinically severe forms of any of the conditions listed in Section 2 of
these Guidelines will not be accepted for venesection and will be referred for treatment at
the appropriate local hospital.

• Patients will be assessed by an NZBS Registered Nurse prior to each procedure. If the
nurse is not satisfied with the patient’s health he/she will not perform the procedure until
the patient has been assessed by a NZBS medical practitioner, where available.

• The minimum haemoglobin concentration prior to each procedure will normally be 110 g/L.

• The venesection will not proceed if BP is >180/100 or if the pulse rate is outside the range
of 50-90 bpm or if the patient has an intercurrent viral infection.

Prepared by: Anup Chand Effective Date: 09/03/2009 Page 1 of 2

Authorised by: Peter Flanagan Previous ID: 111I02501
QA Approved by: Meredith Smith
 NATIONAL
111I02502

GUIDELINES FOR THERAPEUTIC VENESECTION

2. CLINICAL INDICATIONS WHERE NZBS WILL REFER THE PATIENT FOR

VENESECTION IN A HOSPITAL ENVIRONMENT

• Patients aged less than 16 years or 75 years and over.

• Patients of any age suffering from any of the following conditions:

- Severe polycythaemia
- Overt ischaemic heart disease
- Severe hypertension
- Severe hepatic dysfunction
- Severe renal dysfunction
- Cardiomegally/congestive cardiac failure
- Atrial fibrillation where the pulse is outside the limits specified
- Severe chronic obstructive airways disease

3. GUIDELINES FOR VENESECTION AT AN NZBS MOBILE SITE

• Patients who have been accepted as whole blood donors can undergo venesection at
mobile sites provided they do not need any additional blood tests and are in the
maintenance phase of their therapeutic venesection.

• Patients must be aged between 16 and 75 years old.

4. ONGOING CLINICAL MONITORING

The New Zealand Blood Service is not responsible for the ongoing management of secondary
health conditions caused by haemochromatosis as this remains the role of the General Practitioner
or Specialist treating the patient.

Prepared by: Anup Chand Effective Date: 09/03/2009 Page 2 of 2

Authorised by: Peter Flanagan Previous ID: 111I02501
QA Approved by: Meredith Smith