How could COVID-19 impact allograft safety?

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It is well known that viruses can sequester in organs and tissues, creating the possibility of transmission during transplant. Until more is known about COVID-19 transmission and sequestration, it’s best to presume that there could be potential risks to patients receiving allografts. Therefore, implementation of guidelines which restrict tissue donation are necessary to preserve the safety of the nation’s allograft supply.

Fortunately, the Physician’s Council of the American Association of Tissue Banks has issued guidance on this matter to the US tissue banking community. Per Dr. Roman Hitchev of the Association, here is a summary of those guidelines:

  • Travel within the last 28 days prior to donation to an area designated by the CDC as Alert Level 2 or Warning Level 3 may constitute grounds for exclusion of a deceased donor regardless of symptoms, or deferral of a living donor for as much time is necessary to ensure at least 28 consecutive days without symptoms1 following the last travel date to the designated area.
  • Fever with severe acute lower respiratory illness (e.g., pneumonia, ARDS) requiring hospitalization without alternative explanatory diagnosis (e.g., influenza) and without a negative SARS-CoV-2 diagnostic test, may constitute grounds for exclusion of a deceased donor, or deferral of a living donor for as much time is necessary to ensure at least 28 consecutive days without these syndromic symptoms.
  • Close contact3 within the last 28 days prior to donation with a person who has confirmed COVID-19 infection or with a Person under Investigation2 (PUI) as defined by the CDC may constitute grounds for exclusion of a deceased donor, or a deferral of a living donor for as much time is necessary to ensure at least 28 consecutive days without symptoms1 following the contact.
  • Confirmed infection or designation of a Person under Investigation2(PUI) as defined by the CDC within the last 28 days prior to donation may constitute grounds for exclusion of a deceased donor or deferral of a living donor for as much time is necessary to ensure at least 28 consecutive days without symptoms after the PUI status is lifted.  

 

  1. Symptoms: Refer to the CDC website – https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html
  2. Person under Investigation(PUI): Refer to CDC Criteria to Guide Evaluation of PUI for COVID-19 – https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-criteria.html
  3. Close Contact: Refer to the CDC website – https://www.cdc.gov/coronavirus/2019-ncov/faq.html

 

Due to the dynamically changing outbreak geography, medical directors are advised to refer to the CDC on countries at risk for transmission and community spread and the latest travel advisories.

Our country’s tissue banking community is committed to patient safety. The Association and member banks are engaged in research to answer key questions about the new coronavirus and its effects on donated tissues. Allografts.com will be providing updates to the surgical community on the scientific knowledge base as it evolves.