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Update of the opinions on the safety of human body products in the fields of transplantation and MPA with regard to Covid-19

In the context of the Covid-19 pandemic, the High Council for Public Health updates its 2021 and 2022 opinions on the safety of human body products in the fields of transplantation and medically assisted procreation (MPA). In line with updated literature and international recommendations, the main changes introduced by the HCSP are the following:

For tissue donations, asymptomatic or minimally symptomatic donors are no longer tested, the deferral period is reduced from 10 to 7 days for symptomatic and tested-positive donation candidates, and no deferral period is imposed for contact donation candidates, provided that they test negative at the time of donation.

For solid organ donations from living donors, donors continue to be tested by genomic testing of nasopharyngeal swabs; except for life-threatening heart and liver emergencies, transplantation is postponed in the event of a positive test, except in the case of a symptomatic infection that is more than 21 days old and less than 90 days old (subject considered cured); if the donor tested positive is asymptomatic or symptomatic for more than 90 days, the delay in collection is reduced to 7 days instead of 14 days after resolution of symptoms.

In the case of solid organ donations from deceased donors, a genomic test on a nasopharyngeal swab is carried out within 72 hours instead of 48 hours prior to donation. In the event of a positive result, in a donor who has been symptomatic for less than 10 days, the transplant is contraindicated, except in the case of a vital emergency for the heart and liver. It is authorized, with the exception of the lungs and intestine, in the case of a symptomatic infection dating back more than 21 days and less than 90 days (subject considered cured). In all other cases, except for the lungs and intestine, a specific protocol including reinforced post-transplant monitoring may be proposed, after consultation with the recipient, his or her family and the transplant team.

In the case of hematopoietic stem cell donations, different situations are discussed prior to the stimulation of the donor and after the conditioning of the recipient. Newly, only symptomatic donors or donors with recent contact with a Covid-19 subject are subject to genomic testing on nasopharyngeal swabs, whereas previously all donors had to be tested.

In the area of MPA, it is no longer necessary to have the donor sign a consent form or fill in a questionnaire relating to Covid-19; no biological test is required prior to an attempt at MPA; finally, apart from a severe form of Covid-19, the existence of an asymptomatic or moderate infection of Covid-19 should no longer delay MPA procedures.

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