Plasma Donation with Controlled Epilepsy
Individuals with controlled epilepsy can safely donate plasma and are not at increased risk for adverse donation reactions compared to the general donor population. 1, 2
Evidence Supporting Safe Donation
Key Research Findings
The most definitive evidence comes from a prospective study by the American Red Cross in Maryland that actively recruited blood donors with seizure histories over a 2-year period 1, 2:
613 individuals with seizure history donated 723 times with a low adverse reaction rate of 3.34%, compared to 2.24% in the general population—a difference that was not statistically significant 1, 2
Risk of syncope (with or without convulsive activity) was 0.21% in donors with seizures versus 0.28% in other donors, demonstrating no increased risk 1, 2
Among these donors, 25.7% were taking antiepileptic medications and 8.4% had experienced seizures within the preceding year, yet adverse reactions remained rare 1, 2
International Perspective
Despite historical restrictions worldwide based on unfounded concerns about convulsive syncope during donation, evidence demonstrates that rare convulsions during blood donation are actually vasovagal (emotive) syncope, not epileptic seizures 3. Dutch blood bank surveys and international epilepsy league consultations support accepting donors with epilepsy who have been seizure-free for 2 years, regardless of medication status 3.
Practical Recommendations for Acceptance
Donors with controlled epilepsy should be accepted if they meet the following criteria:
- Seizure-free for at least 2 years, with or without antiepileptic medication 3
- No recent seizure activity (ideally none in the preceding year, though the Maryland study included some donors with more recent seizures without increased complications) 1, 2
- Otherwise meet standard donor health requirements for plasma donation 1, 2
Important Caveats
Medication Considerations
Exercise caution with tranexamic acid (TXA) administration in plasma recipients with known seizure history, as TXA increases seizure risk (RR 4.11,95% CI 1.44-11.72), though this risk is small (<1%) and dose-dependent when cumulative doses remain below 50 mg/kg 4. This consideration applies to plasma recipients, not donors.
Donor Safety Monitoring
While donors with epilepsy are not at increased risk, standard monitoring for all plasma donors should include observation for vasovagal reactions (dizziness, nausea, syncope), which occur at similar rates regardless of seizure history 1, 2.
Rationale for Policy Change
Historical restrictions prohibiting blood/plasma donation by individuals with epilepsy are not medically justified and represent outdated policies based on theoretical rather than evidence-based concerns 1, 2. The comprehensive Maryland study definitively demonstrated that these restrictions are unnecessary and exclude a population of willing, safe donors without medical justification 1, 2.