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# Pituitary disorders - Whole blood and components

## Essential information

Obligatory

  Must not donate if:

  1. Malignant tumour.
  2. Part of a multiple endocrine neoplasia (MEN) syndrome.
  3. Has had open neurosurgery.
  4. Ever received injections of human pituitary extract.
  5. Acromegaly or growth hormone excess.
  6. Has adrenal failure, or requires treatment with oral steroids.
  7. Has cranial diabetes insipidus, or syndrome of inappropriate anti-diuretic hormone (SIADH), even if on treatment.
  8. Currently on injectable drug treatment, e.g. pegvisomant (Somavert??).
Discretionary
  1. If a non secretory or prolactin secreting pituitary tumour (adenoma) has been confirmed as non-malignant and the donor has no symptoms, even if on oral medication and/or underwent neurosurgery in the UK after 1992, accept.
  2. If open neurosurgery carried out in the UK after 1992, providing the reason for the surgery is not itself a reason for exclusion, accept.
  3. If it can be shown that dura mater was not used during open neurosurgery in the UK prior to 1992 and there is no evidence of malignancy, the donor may be accepted by a Designated Clinical Support Officer.
  4. If treated, exclusively with recombinant-derived growth hormone, accept. In the UK this has been since 1986.
  5. If the donor has undergone trans-sphenoidal surgery for a pituitary tumour, all wounds are healed, accept.
  6. If the donor has undergone radiation therapy for a benign tumour, even if on long term follow-up, provided there are no complications related to either the treatment received or to the underlying condition, accept.

## Supporting information

See if relevant
  - Central nervous system disease
  - Epilepsy
  - Growth hormone
  - Neurosurgery
  - Prion-associated diseases
  - Surgery
Additional information

  Pituitary adenomas are quite common and the majority are benign, i.e. not able of spreading to other parts of the body (metastasising). Two-thirds of pituitary adenomas remain completely confined to the pituitary gland and approximately one-third will expand into tissues in the immediate vicinity of the gland. Less than 1% of pituitary tumours are malignant.

  Pituitary adenomas may be non-secretory (25%) or secrete hormones such as prolactin (30%), growth hormone (10-15%, leading to acromegaly), ACTH (leading to Cushing's disease), TSH (leading to thyroid dysfunction) or LH/FSH (leading to fertility problems).

  Acromegaly, caused by growth hormone over secretion, is associated with an increased risk of cardiovascular complications, including cardiomyopathy, increase in left ventricular mass, arrhythmias and hypertriglyceridaemia.

  Hypopituitarism, with a reduction in levels of one or more pituitary hormones, can result from either the underlying pituitary condition or its medical/surgical management. A deficiency of ACTH may result in adrenal failure. Pituitary hormones are replaced through medication as required.

  Patients with posterior pituitary lesions may develop diabetes insipidus or hypothalamic problems, which require careful fluid balance. Donating a unit of blood may compromise this balance.

  Sheehan syndrome is post-partum (after the birth of a baby) pituitary necrosis. It is caused by hypovolaemia from post-partum blood loss. It is likely that the patient will have been transfused.

Reason for change:
  This is a new entry.
Version details:

  WB-DSG Edition 203 Release 01 (01 June 2010)

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