Many infections can be spread by donated material. It is important that the donor does not pose a risk of giving an infection to a recipient. Waiting two weeks from when the infection is better and seven days from completing systemic antibiotic, anti-fungal or antiviral treatment makes it much less likely that there will still be a risk of the infection being passed on. It also serves to protect the safety of the donor.
There is no evidence that cold sores or genital herpes can be passed on by transfusion but it is still necessary to wait until any such infection is obviously getting better before allowing anyone to donate.
Three distinct types of influenza infection need to be considered separately: seasonal influenza, pandemic influenza and avian influenza. This guidance applies only to seasonal influenza; avian and pandemic influenza are out with the scope of this guidance. Donors with these diagnoses should not be accepted. Any outbreaks of avian or pandemic influenza will be communicated via public health alert guidance for professionals.
Seasonal influenza in the UK normally extends over a period of approximately 16 weeks during the winter months. Due to the spectrum of disease presentation, only the minority of infected individuals are tested for respiratory viruses and during the annual epidemics, most cases are diagnosed clinically. Systemic infection with viraemia is not a feature of seasonal influenza.
Donors with mild symptoms or recovering from seasonal influenza may be considered for donation following review by the Designated Medical Officer to confirm that the donor if fit enough to undergo the donation process.
If the patient has started conditioning
Common respiratory infections: There is no evidence that common respiratory infections such as colds and sore throats can be transmitted by transfusion. G-CSF may cause side effects that overlap with those of common viruses e.g. headache, myalgia, fatigue but there is no evidence that G-CSF alters the course of such infections. Therefore, the decision on whether a donor can proceed depends on the severity of their symptoms, whether they would tolerate a possible worsening of them and whether they are well enough to travel and undergo a collection procedure or general anaesthetic (for BM).
Other types of infection
Liaison with the transplant centre is key. Sometimes, conditioning can be stopped or paused. Discussion with a microbiologist and the transplant centre may be needed to risk assess whether the donation can proceed. If the donor has a potentially serious infection, the donation may need to be postponed regardless of the patient’s status.
Unusual bacterial/fungal/protozoal infections
Specialist microbiological advice should be sought when considering using cells and tissues from donors who have had unusual infections in the past, including those acquired outside of Western Europe. This should include infections common in immunocompromised patients, or infections which lie dormant or may be difficult to eradicate.
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