Testing donors for SARS-CoV-2
- All of our active UK collection centres are testing for COVID-19 on the day of the medical. The result from the medical will be marked on the donor clearance along with all other infectious diseases.
- If the product is being cryopreserved, donors are tested again on the day of donation (for PBSC collections only on day one). The day-of-donation result will only be communicated to the patient’s transplant centre if positive and should be back within 48 hours but this cannot be guaranteed.
- If the product is not being cryopreserved and will be used fresh the donor, the day-of-donation result will only be communicated to the patient’s transplant centre if positive. Results take a minimum of 24 hours and are usually back within 48 hours, however this cannot be guaranteed and varies by collection centre.
- Many international registries are unable to test for SARS-CoV-2. The international virology checklist, which is completed by the registry at the start of the work up, has been updated to include testing for SARS-CoV-2. This will indicate if testing can be performed and at what point in the process – medical, donation, or both.
- 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) these will be passed onto the transplant centre.
- In addition to testing, donors are screened before attending the collection centre for their medical and again between medical and donation. Full donor health histories are taken at medical. Any donors reporting symptoms will be asked not to attend the collection centre and the transplant centre will be kept up-to-date on the situation.
Verification Typing (VT)
Worldwide, although it has been 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 Anthony Nolan is procuring blood samples for VT testing.
If a donor is unable to provide blood samples, we can instead ask them to provide swab samples. We can then 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). Alternatively, we can provide a donor health and availability check free of charge; we will ask you 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.
- Process – VTs can be requested as normal.
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 deferrals, delays and cancellations can happen at any point.
For this reason, NICE guidance still recommends cryopreservation of requested products.
However, requests for cells for immediate transplantation will be considered on a case by case basis, with the approval of our Donor Consultant, and international registries like NMDP and DKMS Germany have recently updated their cryo policies.
Process – if a request for cells for immediate transplantation is received, we will need supporting information and it will be considered by our Donor Consultant.
For donor and recipient safety, we have reviewed our donation policies and taken the following steps:
- 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, SARS-CoV-2.
- 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.
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.
From 7th July 2020, there are new regulations in place for entering the UK due to coronavirus (COVID-19) that apply to both residents and visitors. These regulations mean that visitors:
- Will need to provide journey and contact details prior to travelling to the UK via the Public Health passenger locator form: https://visas-immigration.service.gov.uk/public-health-passenger-locator...
- Will not be allowed to leave the place they are staying for the first 14 days they are in the UK (known as ‘self-isolating’), except in very limited situations or where country exceptions apply (from 10th July 2020).
International stem cell couriers, importing and exporting cells, are exempt from this self-isolation period, and will be provided with a letter stating this prior to travel, which can be shown to border agents on arrival in the UK.
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
- Patient-donor correspondence is currently being sent by email and the originals will follow once our team is able to access our offices as normal. If any patients wish to contact their donor, we would kindly ask that they send their correspondence by email to their transplant coordinator to send on to the donor.