Steroid therapy - Tissue - deceased donors

Essential information

Obligatory

Discuss with a Designated Clinical Support Officer if:

Has been regularly taking steroid tablets, injections or enemas, or applying creams over large areas.

For information on other situations where steroid therapy may be acceptable, see Immunosuppression and immunodeficiency.

Discretionary
  1. If occasional use of creams over small areas of skin (<9% of body surface area) for minor skin complaints, accept.
  2. If using steroid inhalers for prophylaxis, accept.
  3. Cornea only:
    If corneas are stored in organ culture and in the absence of other contraindications, accept. See Additional information below.

Supporting information

See if relevant
Additional information

Steroid therapy in high doses causes immunosuppression. This may mask infective and inflammatory conditions that would otherwise prevent donation. For further information, refer to Immunosuppression and immunodeficiency.

A small area of skin is defined as <9% (Wallace Rule of Nines). For guidance, 1% is equal to the area of the closed digits and palm of the donor's hand, and 9% is equal to the total area of one arm. Any area >9% is defined as large.

The underlying condition requiring steroid treatment should always be taken into consideration.

Eye donors receiving steroid treatment (e.g. steroid eye drops) should be evaluated on a case-by-case basis, taking into consideration the indication for treatment as well as any possible side effects. Relevant clinical records, especially ophthalmology records, should be reviewed.

Regulatory information

Part of this advice is a requirement of the EU Tissue and Cells Directive.

Reason for change:
Additional information updated to provide guidance on how to assess the area of skin being treated with steroids. Link to ‘Monoclonal antibody therapy and other biological modalities’ entry added.
Version details:

TD-DSG Edition 203 Release 67 (6 October 2026)