Verification Typing (VT)
- Worldwide, it has become increasingly difficult to arrange blood sample collections and shipments from potential donors for VT, because of strict public health guidance, donor willingness and transport challenges.
- For this reason, with immediate effect, Anthony Nolan will temporarily stop providing blood samples at the VT stage for HLA typing and IDM testing.
- Instead, we will provide a donor health and availability check free of charge. If a donor is selected to continue to workup, VT samples will be taken at medical for a concurrent VT and workup. This will help to reduce the frequency of exposure of a donor to healthcare environments.
- We recognise that this will make selection challenging, particularly where CMV status is not available, and this decision has not been taken lightly. We will work with you on a case by case basis and will try to use alternate methods (eg. extended typing from a stored sample) for high resolution typing where possible. This process will also remain under regular review and we will work to provide VT / CMV screening samples as soon as it is safe to do so.
- Process – VTs should be requested as normal. We will carry out a donor health and availability check and will pass the information on as soon as possible.
Provisions and cryopreservation
- As you know, at this time, conditioning a patient prior to safe receipt of the cells is a significant risk. We are working in a constantly changing environment where delays and cancellations can happen at any point.
- For this reason, we now require transplant centres to plan for cryopreservation of all requested products. Requests for cells for immediate transplantation will only be considered in extraordinary circumstances and only with the approval of our Donor Consultant.
- As with our VT policy, this was a difficult decision to make. However, the present risk of a donation or delivery of cells being delayed or falling through at the last minute is just too great.
- Process – all workup requests should be for planned cryopreservation at the transplant centre. If a request for cells for immediate transplantation is received, we will need supporting information and it will need approval by our Donor Consultant. Where there is an existing workup in progress for immediate transplantation and conditioning has begun, we will work to fulfil these requests as planned. Where conditioning has not yet begun, we will get in touch with individual registries to request a switch to planned cryopreservation.
For donor and recipient safety, we have reviewed our donation policies and taken the following steps:
- We are no longer asking donors to provide VT samples at this time.
- We require transplant centres to plan for cryopreservation of the product and not begin conditioning until the product has been safely received.
- We have revised our health history questionnaires to include screening for history of, or exposure to, COVID-19.
- We are in the process of implementing testing of donors at two key points in their donation journey. This will involve COVID-19 testing at medical and:
- For cryopreservation: on the day of donation
- For fresh cells (in exceptional cases only): 1-2 days prior to first day of conditioning
- We are following Public Health England guidance and we are deferring donors who are identified as being part of a risk category.
- We are advising donors to be vigilant in following standard precautions to avoid infection risk and to communicate with us if symptoms develop at any point.
- In the UK, we are working with our aligned registry partners, NHSBT, Welsh Bone Marrow Donor Registry and DKMS UK, to ensure we have a backup UK donor or cord blood unit identified for every UK patient with an upcoming workup.
- Travel disruption continues, but we are working hard to keep everything on track. We have seen a reduction in the number of available flights and that may impact timings of specific import provisions. We’ll continue to keep in regular contact with those affected along the way.
- We have established a UK import and export hub for stem cell transport at Heathrow Airport. The UK leg of all imports and exports will be complete by a UK-based courier, who has been risk-assessed. Products will be transferred at our dedicated hub at the airport.
- We are following any changes in protocol for collection or delivery of cells at individual collection centres and transplant centres.
We are regularly monitoring and reviewing our response to the following risks surrounding donation for transplant:
- Deferral periods for donors with a travel or contact history, or symptoms / confirmation of the virus
- Risk assessment and testing policy for potential donors to protect donor, patient and public health
- National and international travel restrictions that challenge our ability to transport cells
- Restrictions on the travel history of couriers both in the UK and worldwide
- Staffing levels in our collection centres