Bulletin 23-7

AATB Physicians Council Recommends Discontinued Use of SARS-CoV-2/COVID-19 and Mpox Virus (MPXV) Addendums

SARS-CoV-2/COVID-19
In 2020, the AATB Physicians Council formed a standing Panel on COVID-19 to provide ongoing surveillance of the emerging pandemic caused by SARS-CoV-2. This Panel collected data to assess the transmission risk of the SARS-CoV-2 virus in our donor population; the Panel issued recommendations to AATB members for donor evaluation intended to protect recipients and recovery personnel to the extent possible. Refer to previously issued Bulletins on the subject of COVID-19 (Bulletin 20-3* of January 31, 2020, Bulletin 20-7* of February 25, 2020, Bulletin 20-8* of March 4, 2020, Bulletin 20-9* of March 14, 2020, and Bulletin 20-10* of April 2, 2020)*. A new Physicians Council Panel was formed in April 2022 to evaluate the previously issued recommendations, revise them as applicable, and include living donors in the revised recommendations. On May 23, 2022, the Physicians Council published the most recently updated bulletin on SARS-CoV-2/COVID-19 (Bulletin 22-4*).  

The May 23, 2022 bulletin provided comprehensive educational materials for healthcare professionals and included the following information:

  • That the recommendations in the bulletin pertain to all donors (not just deceased donors)
  • Updated travel recommendations (i.e., removed all travel-related donor screening recommendations)
  • Updated donor screening recommendations
  • Updates on donor testing 
  • Statement on Medical Director Discretion

The Physicians Council has recently reviewed available data in light of information regarding the use of UDRAI addendum specific to SARS-CoV-2/COVID-19, and has determined the following:

  • The recommendations contained in Bulletin 22-4 are still valid and relevant
  • The Medical Director has sole discretion regarding the ultimate selection of risk-mitigation criteria pertaining to COVID-19, e.g., travel evaluation, symptomatology, exposure, close contact, infection status, and testing for COVID-19

As such, the AATB Physicians Council recommends that the use of a SARS-CoV-2/COVID-19 addendum is unnecessary, and may be discontinued (if applicable).  


Mpox Virus (MPXV)

  • On August 15, 2022, AATB published information about monkeypox disease (mpox) caused by the mpox virus (MPXV) to educate the tissue community about the ongoing international outbreak. 
  • On September 8, 2022, AATB Physicians Council published Bulletin 22-7*, with recommendations regarding assessing donors for mpox.
    • In that bulletin, donor risk assessment questions that may be used to obtain information specific to screening for risk of mpox were provided.
    • Many providers of electronic UDRAIs included an addendum with these risk assessment questions. 

The Physicians Council has reviewed the current epidemiologic situation related to mpox, including review of the CDC website with information about mpox and information about the mpox outbreak that began to impact the United States in 2022. 

Based on the low number of mpox cases in the US, and that transmission has not spread beyond MSM in the vast majority of cases, the Physicians Council recommends that the mpox addendum be discontinued. Unless there is a significant outbreak, the Physicians Council believes the current UDRAI provides sufficient questions to determine any recent exposures to MPXV, or proxy for risk for exposure, such as vaccination against MPXV, similar to other communicable diseases.  

The recommendations regarding mpox were also reviewed. The Physicians Council believes that should information obtained during the donor history interview and subsequent review of medical records reveal recent exposures to MPXV or certain vaccines, the recommendations regarding donor exclusions are still valid and relevant.  

As a reminder, the disclaimer in the bulletin stated that donor selection based on mpox risk factors or vaccine exposure is subject to medical director discretion. The Physicians Council will continue to monitor the situation with mpox and provide updates, as needed.

 

Above mentioned Bulletins marked with an asterisk (*) have been archived.