In the light of international publications and recommendations, knowledge acquired about the possible transmission of influenzaviruses and SARS-CoV-2 by transplants, changes in the pathogenicity of SARS-CoV-2 and the technical capabilities of genomic diagnosis, the French High Council for Public Health (HCSP) has issued an opinion on the infectious risk of these viruses in solid organ transplants.

For deceased donors, a drastic simplification of measures is recommended, with the main selection criteria being the donor’s pulmonary symptoms and the nature of the organs to be harvested. If the prospective donor has no signs of progressive lower respiratory infection, no SARS-CoV-2 or influenzavirus A/B genome testing is required at respiratory level, with the exception of lung or intestine samples. For these latter samples, it is recommended that a search for the viral genome - SARS-CoV-2, which may be associated with influenzaviruses during epidemic periods, be carried out on a sample of the lower respiratory tract; in the event of positive screening for one of these agents, the samples must be discarded, except in a clinical situation justifying an urgent transplant and on condition of both a normal chest scan and, for SARS-CoV-2, a viral load considered to be low. In the specific situation where the candidate for donation has been admitted to intensive care for an acute respiratory distress syndrome of viral origin, the removal of organs or tissues is contraindicated, regardless of the viral agent involved and the organs concerned.

In the case of living donors, given that only the kidney or a fragment of the liver is donated, the notion of a current viral infection has no impact on the quality of the graft. However, if the prospective donor has an active clinical respiratory infection at the time of donation, a genomic test for SARS-CoV-2 in the upper respiratory tract is recommended; if the result is positive, surgery should be postponed for at least 7 days after the symptoms have disappeared.