JPAC Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee

Hepatitis A

1. Affected Individual
Obligatory

Must not donate if:
1. Less than 6 months from recovery of symptoms, or

2. Less than 6 months since the donor was diagnosed with hepatitis A infection following laboratory testing, or

3. 3. If the donor tested positive for Hepatitis A Virus (HAV) RNA at the time of donation.

Discretionary

1. If less than 6 months from infection, but fully recovered, documented HAV RNA negative and anti-HAV IgG positive after recovery, accept.

2. For tissues that will undergo processing that has been determined to inactivate HAV prior to transplantation, accept.

See if Relevant

Travel

Additional Information

Hepatitis A is a viral infection of the liver, spread by the faecal-oral route and by sewage-contaminated food and water. It can also be spread sexually. There is no long-term infection with the virus but there are reports of transmission by transfusion and organ transplantation. However there have been no documented cases of transmission via tissue allografts. Infection may be symptom free but can be serious and occasionally fatal. The Blood Services do not routinely test tissue donors for this infection, however testing at the time of donation may have been done.

The processing and decontamination protocols applied to certain types of tissue allograft may be sufficient to inactivate the Hepatitis A Virus. Tissue establishments should perform a documented risk assessment to determine which tissues and processes this applies to.

Reason for Change

To add guidance for donors who test positive for HAV RNA at the date of donation, and to allow donation of tissues where the processing and decontamination protocols applied have been determined to inactivate hepatitis A virus.

2. Current or Former Sexual Partner of Affected Individual
Obligatory

Must not donate if less than 6 months:
1. Since a current sexual partner has recovered from symptoms of hepatitis A, or

2. Since a current sexual partner tested positive for Hepatitis A Virus (HAV) RNA, or

3. Since last sexual contact with a former sexual partner who had hepatitis A.

Discretionary

1. If less than 6 months from recovery of current sexual partner, since the current sexual partner tested negative for HAV RNA, or from last sexual contact with a former sexual partner, AND if shown to be immune, accept.

2. For tissues that will undergo processing that has been determined to inactivate HAV prior to transplantation, accept.

Additional Information

There is a risk of transmitting the infection through sexual activity. Infection may be symptom free but can be serious and occasionally fatal. The 6 month exclusion allows any infection to run its natural course and for any risk of passing the infection on through donation to have passed.

The processing and decontamination protocols applied to certain types of tissue allograft may be sufficient to inactivate the Hepatitis A Virus. Tissue establishments should perform a documented risk assessment to determine which tissues and processes this applies to.

Reason for Change

To expand the ‘Obligatory’ and ‘Discretionary’ sections to add guidance for donors whose sexual partner tested positive for HAV RNA within 6 months of the date of donation, and to allow donation of tissues where the processing and decontamination protocols applied have been determined to inactivate Hepatitis A Virus.

3. Person Currently or Formerly Sharing a Home with an Affected Individual
Obligatory

Must not donate if less than 6 months:
1. From recovery of the last affected person in the home, or

2. From the last contact with an affected person if no longer sharing, or

3. Since a person sharing a home tested positive for Hepatitis A  Virus (HAV) RNA.

Discretionary

1. If less than 6 months from recovery of the last affected person in the home, from the last contact if no longer sharing, or since a person sharing a home tested positive for HAV RNA, AND shown to be immune, accept.

2. For tissues that will undergo processing that has been determined to inactivate HAV prior to transplantation, accept.

Additional Information

Because hepatitis A is spread by the faecal - oral route household contacts may easily become infected. Infection may be symptom free but can be serious and occasionally fatal. The 6 month exclusion allows any infection to run its natural course and for any risk of passing the infection on through donation to have passed.

The processing and decontamination protocols applied to certain types of tissue allograft may be sufficient to inactivate the Hepatitis A Virus. Tissue establishments should perform a documented risk assessment to determine which tissues and processes this applies to.

Reason for Change

To expand the ‘Obligatory’ and ‘Discretionary’ sections to add guidance for donors currently or formerly sharing a house with an individual who had tested positive for HAV RNA within 6 months of the date of donation, and to allow donation of tissues where the processing and decontamination protocols applied have been determined to inactivate Hepatitis A Virus.

4. Immunisation
Obligatory

Known exposure.
Must not donate if:

Less than six months after vaccine or intramuscular immunoglobulin was given.

Discretionary

1. No known exposure to Hepatitis A Virus, accept.

2. For tissues that will undergo processing that has been determined to inactivate Hepatitis A Virus prior to transplantation, accept.

See if Relevant

Hepatitis B - 6. Hepatitis B Immunisation
Travel

Additional Information

Hepatitis A immunisation is advised before travel to parts of the world where other infections relevant to donating such as malaria are common. The donor should be asked about any relevant travel history.

Hepatitis A immunisation may be combined with Hepatitis B immunisation.

If less than 6 months from immunisation following known exposure, the donor may be accepted following individual risk assessment.

Reason for Change

To allow donation of tissues where the processing and decontamination protocols applied have been determined to inactivate Hepatitis A Virus.

Update Information

This entry was last updated in
TL-DSG Edition 203 Release 59