*Note that there is evidence that SARS-CoV-2 RNA can remain detectable by PCR in nasopharyngeal samples for an extended period after full recovery. Nasopharyngeal shedding does not equate to viraemia, and other coronaviruses (including SARS and MERS) have not displayed any transmissibility via blood or HPC. Nonetheless a donor with detectable nasopharyngeal SARS-CoV-2 RNA could be considered seen as a potential infective risk to staff and other donors at a collection centre.
Collection should be deferred for 4 weeks 28 days after any international travel. Even in countries where local transmission of COVID-19 is high, people who have travelled internationally are at particular risk of exposure. If the patient’s need for transplant is urgent, the donor is completely well and there are no suitable alternative donors, earlier collection may be considered if local public health requirements permit, subject to careful risk assessment.
To identify countries where local transmission of COVID-19 is high, registries may refer to national health authorities and/or trans-national sources such as WHO and ECDC. Following the spread of the pandemic to nearly all developed countries, however, it may be more realistic to define geographical risk in terms of whether the donor’s community exposure risk exceeds that of the patient. In the absence of known contact with COVID-19, risk assessment should take into account:
- The level of risk and applicable public health restrictions in the donor’s region.
- Any recent travel to higher-risk regions within the same country.
- Any contact with a person with known COVID-19 infection.
In a healthy donor without symptoms, routine pre-donation testing confers should not be considered necessary because there is no known benefit to the recipient. However, there is potential There may be value in avoiding G-CSF during the incubation period of COVID-19, as well as potential benefit to staff and others at the collection centre by identifying a pre-symptomatic donor infection, but such benefits should be limited if the donor is counselled to minimise risk exposure.
However, it is acknowledged that many jurisdictions have recommended or even mandated routine pre-donation screening of HPC donors.
In the absence of symptoms, testing the donor for COVID-19 on the day of collection is not recommended because: