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Cell, tissue and organ donor selection in response to new SARS-CoV-2 variants

The French High Council for Public Health (HCSP) has updated its opinion of March 9, 2021 on the safety of organ, tissue and cell (OTC) donations in the context of the Covid-19 pandemic, taking into account the appearance of SARS-CoV-2 variants (VOI for variant of interest) in France.

Particular attention is paid to the 20C/H655Y variant known as "Breton" which seems difficult to detect in upper airway samples by RT-PCR, whereas the 19B/501Y variant known as "Mondor" does not pose any practical problem of recognition by the usual tests.

Suspicion of exposure of CTO donors to the 20C/H655Y variant is essentially based on the criteria of residence or stay in a geographical area that includes part of the departments of Côtes d’Armor and Finistère, and of contact cases from this area.

In this geographical context, the HCSP recommends the following:

  • For living donors:
  • In all cases, propose a 14-day postponement of the donation.
  • In case of urgent donation, especially for haematopoietic stem cell (HSC) donations, perform a deep swab (good quality spontaneous or induced sputum) for SARS-CoV-2 RNA detection, in addition to the usual nasopharyngeal swab.
  • For deceased donors:
  • For beating-heart patients who may be organ and possibly tissue donors, perform a deep collection (bronchoalveolar lavage or tracheobronchial aspiration) for SARS-CoV-2 RNA detection in addition to the nasopharyngeal collection and at the same time; which does not pose any technical difficulty given that these patients are intubated-ventilated
  • For donors of tissue taken from the mortuary, postpone these samples insofar as it is not possible to take a deep respiratory sample of good quality.

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