Guidance

2 Pre-transplant care

2 Pre-transplant care

Transplant recipients

Reducing risk

2.1 Advise patients that for at least 2 weeks before having haematopoietic stem cell transplantation (HSCT), they should follow the professional advice from their clinical team on how best to minimise their risk of respiratory infections (including COVID-19). Guidance for clinicians and patients to support risk assessments is available on the British Society of Blood and Marrow Transplantation and Cellular Therapy (BSBMTCT) website. [July 2020]

2.2 Test patients for respiratory viruses, including for SARS-CoV-2:

  • within 7 days before admission and

  • on admission before starting conditioning. [Amended September 2023]

2.3 Consider deferring allogeneic HSCT if the patient has been in close contact with someone with COVID-19 in the past week. Assess the risks for the individual patient of having COVID-19 against the benefits of having HSCT without delay. [Amended July 2022]

Assessing when to use cryopreserved cells

2.4 Transplant centres should use fresh donations routinely and only use cryopreserved donations in exceptional circumstances. [Amended September 2023]

2.5 If cryopreserved cells are used, they should be received by the transplant centre before conditioning starts, unless exceptional circumstances mean this is not possible. [Amended September 2023]

Transplant donors

Reducing risk

2.6 Explain to donors the importance of minimising their risk of exposure to COVID-19 before donation. Give advice on reducing risk in line with the UK government guidance on living safely with respiratory infections, including COVID-19. [Amended July 2022]

2.7 Explain to donors about the symptoms of COVID‑19, and discuss transmission risks, donation restrictions and when to consider self-deferring from donating. [Amended September 2023]

2.8 This recommendation has been deleted. [September 2023]

2.9 This recommendation has been deleted. [September 2023]

2.10 Tell donors to contact the coordinating registry and the collection centre at which they donated if they develop any illness within 2 weeks after donating. [April 2020]

Donors with COVID‑19

2.11 For HPC apheresis or mononuclear cell (MNC) donors who have symptoms of COVID-19:

  • defer donations by 14 days from when their symptoms resolve or

  • if donation is urgent and less than 14 days have passed since symptoms have resolved, refer to a designated donor medical officer for risk assessment and earlier discretionary clearance. [Amended September 2023]

2.12 For HPC marrow donors who have symptoms of COVID-19, defer donations for a period of time agreed in discussion with an anaesthetist. [Amended September 2023]

2.13 If a donor has symptoms of COVID-19 at a late stage, after conditioning has started, discuss with the donor registry and the collection centre whether a SARS-CoV-2-positive donation can be accepted safely. [Amended September 2023]