The Search Team continues to provide searches of the UK aligned registry and the international stem cell donor registries for UK patients as usual. We will provide our Transplant Centres with updates in the event that individual registries are unable to provide search results due to local COVID-19 restrictions. We are also happy to provide assistance with the identification of a UK-based back up donor or cord blood unit(s) should these be required, especially in the case of patients who are at workup for a donation of fresh cells. Please contact your Search Coordinator in the event that you require our help with such cases.
Non-AN Donor VT
Currently, the majority of the international registries are able to provide blood samples for donors requested for VT. NMDP (US) donors are only providing buccal swab samples at the VT stage. If your H&I Laboratory is unable to accept buccal swabs for testing, NMDP are able to arrange for the testing of these samples within their own laboratories; please advise your Search Coordinator accordingly at the time of submitting your VT request for an NMDP donor. In the event that local COVID-19 restrictions prevent additional registries from providing blood samples for VT requests, we will provide updates as soon as we are notified of a change to their VT processes.
Verification Typing (VT) for Anthony Nolan Donors
- Anthony Nolan is procuring blood samples for VT testing – VTs can be requested as normal.
- If a donor is unable to provide blood samples, we can instead ask them to provide swab samples and we will perform a pre-VT test at our Anthony Nolan Labs. (Please note: CMV testing is carried out using a buccal swab sample. This is not an accredited process in our laboratory, however, an application to obtain accreditation is currently in progress. Therefore, the result provided is for information only and we recommend confirmation of CMV status prior to final donor selection).
- We can provide a donor health and availability check free of charge if this your preference.
- If a donor who has provided swab samples or a health and availability check is selected to continue to workup, VT samples will be taken at medical for a concurrent VT and workup.
Workups and Provisions
To ensure donor and patient safety during this time, our donation polices have been reviewed and the following steps have been taken:
- We are following the Public Health England guidance and deferring donors who are identified as being part of a risk category.
- Donors are fully screened before attending the collection centre for their Medical and again between Medical and Donation.
- Donors are advised to follow comprehensive social distancing for 10 days prior to Donation; this time frame is reviewed regularly as government guidance is updated.
- Donors are advised to communicate with us immediately if they develop symptoms at any point of the donation process or are exposed to COVID-19.
- Our Health History Questionnaire has been reviewed to include screening for history of or exposure to COVID-19.
- Our Donor Follow-Up team are currently calling donors on day 2 or 3, day 7 and day 14 post donation. If the donor reports any COVID-19 symptoms (regardless of whether they tested positive or negative on day of collection), this will be passed on to the Transplant Centre.
Due to the constant changing environment where deferrals, delays and cancellations can happen at any point and in keeping with NICE Guidance, we are advising all Transplant Centres to plan for cryopreservation of product and to begin conditioning after the product has been safely received. International registries’ policies may differ to Anthony Nolan’s. NMDP and DKMS Germany have recently updated their cryo policies.
Requests for cells for immediate transplant will be accepted, however, the Transplant Centre must confirm they wish to proceed with the risks involved. We are requesting that, in the event of a fresh cell request, Transplant centres identify a backup donor or cord for their patient. If the Transplant Centre needs help identifying a backup donor, our Search team will be able to assist.
All our UK collection centres are testing for COVID-19 in accordance with NICE Guidelines as per the following:
- Donors are tested on the day of the Medical; the result will be marked on the donor clearance along with all other IDM results.
- Where product is being cryopreserved, donors are tested on day of Donation (Day 1 for PBSC). The result will only be communicated to the Transplant Centre if positive. We aim to have the result within 24 - 48 hours but this cannot be guaranteed.
- If the product will be used fresh, the donor will be tested within 3 days of the patient’s planned conditioning date. The result will only be communicated to the Transplant Centre if positive. We aim to have the result within 24 - 48 hours but this cannot be guaranteed.
- Where some Collection Centre trusts require additional COVID-19 testing, the result would only be communicated to the Transplant Centre if positive.
Many international registries are unable to test for COVID-19. The international virology checklist which is completed by the registry at the start of the work up has been updated to including testing for COVID-19. This form will be sent to the Transplant Centre in advance of the Medical and indicate if testing can be performed and at what point in the process – Medical, Donation or both.
- All Patient-donor correspondence is being sent by email.
- If a patient wishes to write to their donor, please advise the patient to send it by email either to their transplant coordinator, which will be emailed to the donor follow up team or directly to the donor follow up team using firstname.lastname@example.org.
- Correspondence received from their donor will be emailed by the donor follow up team to their transplant coordinator, to pass to the patient.
- Any correspondence received at our office will be scanned, sent on by email and then securely stored.
- 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.
- Our UK import and export hub for stem cell transport has now moved to our Head Offices in Hampstead, London. This will be used to transfer products between international and UK-based couriers, where necessary. Some hospitals are now allowing international couriers to pick up/deliver directly and we will be in contact with centres to ensure we follow their preferred procedure.
- We are following any changes in protocol for collection or delivery of cells at individual collection centres and transplant centres.
- International stem cell couriers importing and exporting cells are exempt from quarantine rules and will be provided with a letter stating this prior to travel, which can be shown to border agents on arrival in the UK.