Anthony Nolan Medical Guidelines - User contributions [en]

Epstein-Barr Virus

2020-01-10T14:22:18Z

MariaCuadrado: /* Outcomes and recommended actions based on EBV serology and PCR: */

==Condition==
Herpes virus causing glandular fever (infectious mononucleosis).

==Individual at risk==
Recipient (and ?donor)

==Guidance at RECRUITMENT==
ACCEPTABLE

==Guidance at CT==
ACCEPTABLE

==Guidance at Work-up==

The following serological tests should be obtained

• VCA-IgM

• VCA-IgG

• (EBNA-IgG)

===Outcomes and recommended actions based on EBV serology and PCR:===

'''Potential serology/PCR combinations:'''

1) '''VCA-IgM neg AND VCA-IgG pos or neg.

'''

''''Donor can be cleared - transplant centre should be informed for serological/PCR status''

''

2) '''VCA-IgM-pos AND VCA-IgG and/or EBNA positive
'''

Inform the TC and proceed donation without EBV-DNA PCR

3)'''VCA-IgM-pos AND VCA-IgG and/or EBNA weak or negative

Request EBV-DNA PCR

a) If EBV-DNA PCR negative--> inform the TC and proceed donation

b) If EBV-DNA PCR positive --> inform the TC, donation will have to be postponed and EBV serology repeated after 1 month.

==Justification for guidance==
Primary EBV infection or reactivation in a transplant recipient is associated with post-transplant lymphoproliferative disease, amongst other morbidity.

==References==
Buisson, M., Fleurent, B., Mak, M., Morand, P., Chan, L., Ng, A., … Seigneurin, J. M. (1999). Novel Immunoblot Assay Using Four Recombinant Antigens for Diagnosis of Epstein-Barr Virus Primary Infection and Reactivation. Journal of Clinical Microbiology, 37(8), 2709–2714. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103296/]

APA Recommendations of the Center for International Blood and Marrow Transplant Research (CIBMTR®), the National Marrow Donor Program (NMDP), the European Blood and Marrow Transplant Group (EBMT), the American Society of Blood and Marrow Transplantation (ASBMT), the Canadian Blood and Marrow Transplant Group (CBMTG), the Infectious Disease Society of America (IDSA), the Society for Healthcare Epidemiology of America (SHEA), the Association of Medical Microbiology and Infectious Diseases Canada (AMMI), and the Centers for Disease Control and Prevention (CDC), Tomblyn, M., Chiller, T., Einsele, H., Gress, R., Sepkowitz, K., … Boeckh, M. A. (2009). Guidelines for Preventing Infectious Complications among Hematopoietic Cell Transplant Recipients: A Global Perspective. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 15(10), 1143–1238. doi:10.1016/j.bbmt.2009.06.019 [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC85323/]

==Version==
Version 2, Edition 1

====Date of Last Update====
3 March 2016

Epstein-Barr Virus

2020-01-10T14:21:53Z

MariaCuadrado: /* Outcomes and recommended actions based on EBV serology and PCR: */

==Condition==
Herpes virus causing glandular fever (infectious mononucleosis).

==Individual at risk==
Recipient (and ?donor)

==Guidance at RECRUITMENT==
ACCEPTABLE

==Guidance at CT==
ACCEPTABLE

==Guidance at Work-up==

The following serological tests should be obtained

• VCA-IgM

• VCA-IgG

• (EBNA-IgG)

===Outcomes and recommended actions based on EBV serology and PCR:===

'''Potential serology/PCR combinations:'''

1) '''VCA-IgM neg AND VCA-IgG pos or neg.

'''

''Donor can be cleared - transplant centre should be informed for serological/PCR status''

2) '''VCA-IgM-pos AND VCA-IgG and/or EBNA positive
'''

Inform the TC and proceed donation without EBV-DNA PCR

3)'''VCA-IgM-pos AND VCA-IgG and/or EBNA weak or negative

Request EBV-DNA PCR

a) If EBV-DNA PCR negative--> inform the TC and proceed donation

b) If EBV-DNA PCR positive --> inform the TC, donation will have to be postponed and EBV serology repeated after 1 month.

==Justification for guidance==
Primary EBV infection or reactivation in a transplant recipient is associated with post-transplant lymphoproliferative disease, amongst other morbidity.

==References==
Buisson, M., Fleurent, B., Mak, M., Morand, P., Chan, L., Ng, A., … Seigneurin, J. M. (1999). Novel Immunoblot Assay Using Four Recombinant Antigens for Diagnosis of Epstein-Barr Virus Primary Infection and Reactivation. Journal of Clinical Microbiology, 37(8), 2709–2714. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103296/]

APA Recommendations of the Center for International Blood and Marrow Transplant Research (CIBMTR®), the National Marrow Donor Program (NMDP), the European Blood and Marrow Transplant Group (EBMT), the American Society of Blood and Marrow Transplantation (ASBMT), the Canadian Blood and Marrow Transplant Group (CBMTG), the Infectious Disease Society of America (IDSA), the Society for Healthcare Epidemiology of America (SHEA), the Association of Medical Microbiology and Infectious Diseases Canada (AMMI), and the Centers for Disease Control and Prevention (CDC), Tomblyn, M., Chiller, T., Einsele, H., Gress, R., Sepkowitz, K., … Boeckh, M. A. (2009). Guidelines for Preventing Infectious Complications among Hematopoietic Cell Transplant Recipients: A Global Perspective. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 15(10), 1143–1238. doi:10.1016/j.bbmt.2009.06.019 [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC85323/]

==Version==
Version 2, Edition 1

====Date of Last Update====
3 March 2016

Epstein-Barr Virus

2020-01-10T14:21:15Z

MariaCuadrado: /* Outcomes and recommended actions based on EBV serology and PCR: */

==Condition==
Herpes virus causing glandular fever (infectious mononucleosis).

==Individual at risk==
Recipient (and ?donor)

==Guidance at RECRUITMENT==
ACCEPTABLE

==Guidance at CT==
ACCEPTABLE

==Guidance at Work-up==

The following serological tests should be obtained

• VCA-IgM

• VCA-IgG

• (EBNA-IgG)

===Outcomes and recommended actions based on EBV serology and PCR:===

'''Potential serology/PCR combinations:'''

1) '''VCA-IgM neg AND VCA-IgG pos or neg.

'''

''Donor can be cleared - transplant centre should be informed for serological/PCR status''

2) '''VCA-IgM-pos AND VCA-IgG and/or EBNA positive
'''
Inform the TC and proceed donation without EBV-DNA PCR

3)'''VCA-IgM-pos AND VCA-IgG and/or EBNA weak or negative

Request EBV-DNA PCR

a) If EBV-DNA PCR negative--> inform the TC and proceed donation

b) If EBV-DNA PCR positive --> inform the TC, donation will have to be postponed and EBV serology repeated after 1 month.

==Justification for guidance==
Primary EBV infection or reactivation in a transplant recipient is associated with post-transplant lymphoproliferative disease, amongst other morbidity.

==References==
Buisson, M., Fleurent, B., Mak, M., Morand, P., Chan, L., Ng, A., … Seigneurin, J. M. (1999). Novel Immunoblot Assay Using Four Recombinant Antigens for Diagnosis of Epstein-Barr Virus Primary Infection and Reactivation. Journal of Clinical Microbiology, 37(8), 2709–2714. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103296/]

APA Recommendations of the Center for International Blood and Marrow Transplant Research (CIBMTR®), the National Marrow Donor Program (NMDP), the European Blood and Marrow Transplant Group (EBMT), the American Society of Blood and Marrow Transplantation (ASBMT), the Canadian Blood and Marrow Transplant Group (CBMTG), the Infectious Disease Society of America (IDSA), the Society for Healthcare Epidemiology of America (SHEA), the Association of Medical Microbiology and Infectious Diseases Canada (AMMI), and the Centers for Disease Control and Prevention (CDC), Tomblyn, M., Chiller, T., Einsele, H., Gress, R., Sepkowitz, K., … Boeckh, M. A. (2009). Guidelines for Preventing Infectious Complications among Hematopoietic Cell Transplant Recipients: A Global Perspective. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 15(10), 1143–1238. doi:10.1016/j.bbmt.2009.06.019 [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC85323/]

==Version==
Version 2, Edition 1

====Date of Last Update====
3 March 2016

Brain Injury

2019-11-27T12:37:15Z

MariaCuadrado:

'''Acceptability at recruitment'''

Acceptable

'''Acceptability at CT/Work Up'''

Acceptable

'''Individual Risk'''

Donor

'''Explanation of condition'''

A common form of brain trauma is a concussion which is a traumatic injury that alters the way the brain functions. Effects are usually temporary but can include headaches and problems with concentration,
memory, balance and coordination. Although concussions usually are caused by a blow to the head, they can also occur when the head and upper body are violently shaken. Other terms for concussion are “mild traumatic brain injury” or MTBI.
For purposes of volunteer donor assessment, a concussion must have been medically diagnosed by a physician or other medical personnel or met concussion criteria through sports assessment by a trainer or coach. Other serious injuries of the brain that may not have been specifically diagnosed as a concussion should also be taken into consideration in this assessment.

'''Guidance'''

• '''Acceptable''' if superficial injury (such as scalp wound requiring only stitches) with no reported neurological symptoms.

• '''Unacceptable''' if:

- More than 6 concussions in a lifetime

- Symptoms from a concussion that lasted more than a month

- Severe concussion with a period of unconsciousness more than 1 hour

• '''Just for BM''' (PBSC could increase re-bleeding risk) if:

- More than 3 concussions (but less than 6)

- More than 5 minutes loss of consciousness (but less than 1 hour)

- More than 72 hours to recover from any neurological symptoms (short term memory loss, blurred vision, light or noise sensitivity, nausea or vomiting, dizziness or balance problems, difficulty thinking, poor concentration, seizure, personality changes, severe headache).

• '''For rest of brain injuries (discuss with medical officer)''' :

- Make TU for PBSC until more than 12 months from most recent injury

- Make TU for BM until more than 6 months from most recent injury

Brain Injury

2019-11-27T12:36:18Z

MariaCuadrado:

Brain Injury

2019-11-27T12:35:50Z

MariaCuadrado:

Brain Injury

2019-11-27T12:35:05Z

MariaCuadrado:

'''Acceptability at recruitment'''

Acceptable

'''Acceptability at CT/Work Up'''

Acceptable

'''Individual Risk'''

Donor

'''Explanation of condition'''

A common form of brain trauma is a concussion which is a traumatic injury that alters the way the brain functions. Effects are usually temporary but can include headaches and problems with concentration,
memory, balance and coordination. Although concussions usually are caused by a blow to the head, they can also occur when the head and upper body are violently shaken. Other terms for concussion are “mild traumatic brain injury” or MTBI.
For purposes of volunteer donor assessment, a concussion must have been medically diagnosed by a physician or other medical personnel or met concussion criteria through sports assessment by a trainer or coach. Other serious injuries of the brain that may not have been specifically diagnosed as a concussion should also be taken into consideration in this assessment.

'''Guidance'''

• '''Acceptable''' if superficial injury (such as scalp wound requiring only stitches) with no reported neurological symptoms.

• '''Unacceptable''' if:
- More than 6 concussions in a lifetime
- Symptoms from a concussion that lasted more than a month
- Severe concussion with a period of unconsciousness more than 1 hour

• '''Just for BM''' (PBSC could increase re-bleeding risk) if:
- More than 3 concussions (but less than 6)
- More than 5 minutes loss of consciousness (but less than 1 hour)
- More than 72 hours to recover from any neurological symptoms (short term memory loss, blurred vision, light or noise sensitivity, nausea or vomiting, dizziness or balance problems, difficulty thinking, poor concentration, seizure, personality changes, severe headache).

• '''For rest of brain injuries (discuss with medical officer)''' :
- Make TU for PBSC until more than 12 months from most recent injury
- Make TU for BM until more than 6 months from most recent injury

Brain Injury

2019-11-27T12:34:36Z

MariaCuadrado:

'''Acceptability at recruitment'''

Acceptable

'''Acceptability at CT/Work Up'''

Acceptable

'''Individual Risk'''

Donor

'''Explanation of condition'''
A common form of brain trauma is a concussion which is a traumatic injury that alters the way the brain functions. Effects are usually temporary but can include headaches and problems with concentration,

memory, balance and coordination. Although concussions usually are caused by a blow to the head, they can also occur when the head and upper body are violently shaken. Other terms for concussion are “mild traumatic brain injury” or MTBI.
For purposes of volunteer donor assessment, a concussion must have been medically diagnosed by a physician or other medical personnel or met concussion criteria through sports assessment by a trainer or coach. Other serious injuries of the brain that may not have been specifically diagnosed as a concussion should also be taken into consideration in this assessment.

'''Guidance'''

• '''Acceptable''' if superficial injury (such as scalp wound requiring only stitches) with no reported neurological symptoms.

• '''Unacceptable''' if:
- More than 6 concussions in a lifetime
- Symptoms from a concussion that lasted more than a month
- Severe concussion with a period of unconsciousness more than 1 hour

• '''Just for BM''' (PBSC could increase re-bleeding risk) if:
- More than 3 concussions (but less than 6)
- More than 5 minutes loss of consciousness (but less than 1 hour)
- More than 72 hours to recover from any neurological symptoms (short term memory loss, blurred vision, light or noise sensitivity, nausea or vomiting, dizziness or balance problems, difficulty thinking, poor concentration, seizure, personality changes, severe headache).

• '''For rest of brain injuries (discuss with medical officer)''' :
- Make TU for PBSC until more than 12 months from most recent injury
- Make TU for BM until more than 6 months from most recent injury

Brain Injury

2019-11-27T12:33:58Z

MariaCuadrado:

'''Acceptability at recruitment'''

Acceptable

'''Acceptability at CT/Work Up'''

Acceptable

'''Individual Risk'''

Donor

'''Explanation of condition'''
A common form of brain trauma is a concussion which is a traumatic injury that alters the way the brain functions. Effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination. Although concussions usually are caused by a blow to the head, they can also occur when the head and upper body are violently shaken. Other terms for concussion are “mild traumatic brain injury” or MTBI.
For purposes of volunteer donor assessment, a concussion must have been medically diagnosed by a physician or other medical personnel or met concussion criteria through sports assessment by a trainer or coach. Other serious injuries of the brain that may not have been specifically diagnosed as a concussion should also be taken into consideration in this assessment.

'''Guidance'''

• '''Acceptable''' if superficial injury (such as scalp wound requiring only stitches) with no reported neurological symptoms.

• '''Unacceptable''' if:
- More than 6 concussions in a lifetime
- Symptoms from a concussion that lasted more than a month
- Severe concussion with a period of unconsciousness more than 1 hour

• '''Just for BM''' (PBSC could increase re-bleeding risk) if:
- More than 3 concussions (but less than 6)
- More than 5 minutes loss of consciousness (but less than 1 hour)
- More than 72 hours to recover from any neurological symptoms (short term memory loss, blurred vision, light or noise sensitivity, nausea or vomiting, dizziness or balance problems, difficulty thinking, poor concentration, seizure, personality changes, severe headache).

• '''For rest of brain injuries (discuss with medical officer)''' :
- Make TU for PBSC until more than 12 months from most recent injury
- Make TU for BM until more than 6 months from most recent injury

Brain Injury

2019-11-27T12:33:07Z

MariaCuadrado: Created page with "'''Acceptability at recruitment''' Acceptable '''Acceptability at CT/Work Up''' Acceptable '''Individual Risk''' Donor '''Explanation of condition''' A common fo..."

'''Acceptability at recruitment'''
Acceptable

'''Acceptability at CT/Work Up'''
Acceptable

'''Individual Risk'''
Donor

'''Explanation of condition'''
A common form of brain trauma is a concussion which is a traumatic injury that alters the way the brain functions. Effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination. Although concussions usually are caused by a blow to the head, they can also occur when the head and upper body are violently shaken. Other terms for concussion are “mild traumatic brain injury” or MTBI.
For purposes of volunteer donor assessment, a concussion must have been medically diagnosed by a physician or other medical personnel or met concussion criteria through sports assessment by a trainer or coach. Other serious injuries of the brain that may not have been specifically diagnosed as a concussion should also be taken into consideration in this assessment.

'''Guidance'''

• '''Acceptable''' if superficial injury (such as scalp wound requiring only stitches) with no reported neurological symptoms.

• '''Unacceptable''' if:
- More than 6 concussions in a lifetime
- Symptoms from a concussion that lasted more than a month
- Severe concussion with a period of unconsciousness more than 1 hour

• '''Just for BM''' (PBSC could increase re-bleeding risk) if:
- More than 3 concussions (but less than 6)
- More than 5 minutes loss of consciousness (but less than 1 hour)
- More than 72 hours to recover from any neurological symptoms (short term memory loss, blurred vision, light or noise sensitivity, nausea or vomiting, dizziness or balance problems, difficulty thinking, poor concentration, seizure, personality changes, severe headache).

• '''For rest of brain injuries (discuss with medical officer)''' :
- Make TU for PBSC until more than 12 months from most recent injury
- Make TU for BM until more than 6 months from most recent injury

Malaria

2019-11-15T17:19:09Z

MariaCuadrado: /* Guidance */

==Acceptability at Recruitment==
QUALIFIED

==Acceptability at CT / Work-Up==
QUALIFIED

==Individual at Risk==
Recipient

==Explanation of Condition==
Parasitic infection transmitted by the bite of a female mosquito. Untreated, the condition may be rapidly fatal.

See also [http://en.wikipedia.org/wiki/Malaria Malaria]

==Guidance==
'''a) Donors who have had malaria diagnosed in the past:'''
If more than three years have passed since anti-malaria therapy has been completed and symptoms caused by malaria have resolved, accept.
If the donor (with a history of malaria) has revisited a malaria endemic area and at least four months have passed since return, accept.

A test for malaria antibody will be performed at medical.

'''b) Donors who have EVER had an undiagnosed fever that could have been malaria while in a malaria area or within four months of leaving a malaria endemic area:'''
If at least four months have passed since the donor returned from the malaria endemic area, or from the date of recovery from symptoms (undiagnosed fever) that may have been caused by malaria, whichever is later, accept.
NB. this may have to be increased to six months if the area is also identified as a risk area for T. cruzi or a tropical virus; the longest stipulated deferral period must be applied

A test for malaria antibody will be performed at medical.

'''c) Donors who have EVER been resident in a malaria endemic area for six months or more:'''
If at least four months have passed since the date of the last potential exposure to malaria, accept.

A test for malaria antibody will be performed at medical.

'''d) For all other donors:'''

-If at least four months and less than 12 months have passed since return from a malaria endemic area, and a validated test for malaria antibody at medical is negative, accept.

-If travel to a malaria endemic area is more than 12 months prior to donation and the donor has never been diagnosed with malaria, has never had an undiagnosed fever while abroad or within four months of leaving a malaria endemic area and has not lived in a malaria endemic area for a continuous period of six months or more at any time of life, the donor can be accepted without the need for malaria antibody testing.

-If less than four months have passed, and if the donor has taken a full course of prophylaxis, the donor may proceed at the transplant centre's discretion. A malaria antibody test will be performed at medical. Inform Transplant Centre at VT

==Pseudonyms or Related Conditions==

==Version==
Version 2, Edition 1

====Date of Last Update====
1 June 2016

PrEP

2018-11-28T15:57:53Z

MariaCuadrado: /* Acceptability at CT / Work-Up */

PrEP – Pre-Exposure Prophylaxis

==Acceptability at Recruitment==
ACCEPTABLE

==Acceptability at CT / Work-Up==
AT VT --> ACCEPTABLE in potential donors who have been off PrEP (and therefore low-risk sexual behaviour) for at least 3 months

At Medical --> Inform the TC

==Individual at Risk==
Recipient

==Explanation of Condition==
Pre-Exposure Prophylaxis (PrEP) is a course of HIV drugs (Truvada= tenofovir + emtricitabine) taken by HIV negative people who are at high risk of infection with HIV. It lowers the risk of becoming HIV positive. It can be taken either regularly or “on-demand” (before and after sexual encounters).

==Justification for guidance==
Similar to High Risk Sexual Behaviour:
With use of modern screening techniques, the risk of unintended transmission of an infectious disease is very small. Stem cell donors undergo in-depth medical and sexual health questionnaires, and will have a face-to-face interview with donor centre staff, allowing ample opportunity to identify those donors at increased risk of contracting a window-period infection.

In many cases, the benefit to the recipient of receiving a donation will vastly outweigh the risk of transmission of an infectious agent. Therefore, this time period me be reduced at the discretion of the requesting transplant centre.

PrEP

2018-11-27T18:19:43Z

MariaCuadrado: /* Acceptability at CT / Work-Up */

PrEP – Pre-Exposure Prophylaxis

==Acceptability at Recruitment==
ACCEPTABLE

==Acceptability at CT / Work-Up==
AT VT --> ACCEPTABLE in potential donors who has been off PrEP (and therefore low-risk sexual behaviour) for at least 3 months

At Medical --> Inform the TC

==Individual at Risk==
Recipient

==Explanation of Condition==
Pre-Exposure Prophylaxis (PrEP) is a course of HIV drugs (Truvada= tenofovir + emtricitabine) taken by HIV negative people who are at high risk of infection with HIV. It lowers the risk of becoming HIV positive. It can be taken either regularly or “on-demand” (before and after sexual encounters).

==Justification for guidance==
Similar to High Risk Sexual Behaviour:
With use of modern screening techniques, the risk of unintended transmission of an infectious disease is very small. Stem cell donors undergo in-depth medical and sexual health questionnaires, and will have a face-to-face interview with donor centre staff, allowing ample opportunity to identify those donors at increased risk of contracting a window-period infection.

In many cases, the benefit to the recipient of receiving a donation will vastly outweigh the risk of transmission of an infectious agent. Therefore, this time period me be reduced at the discretion of the requesting transplant centre.

PrEP

2018-11-27T18:18:18Z

MariaCuadrado: /* Acceptability at CT / Work-Up */

PrEP – Pre-Exposure Prophylaxis

==Acceptability at Recruitment==
ACCEPTABLE

==Acceptability at CT / Work-Up==
ACCEPTABLE in potential donors who has been off PrEP (and therefore low-risk sexual behaviour) for at least 3 months

==Individual at Risk==
Recipient

==Explanation of Condition==
Pre-Exposure Prophylaxis (PrEP) is a course of HIV drugs (Truvada= tenofovir + emtricitabine) taken by HIV negative people who are at high risk of infection with HIV. It lowers the risk of becoming HIV positive. It can be taken either regularly or “on-demand” (before and after sexual encounters).

==Justification for guidance==
Similar to High Risk Sexual Behaviour:
With use of modern screening techniques, the risk of unintended transmission of an infectious disease is very small. Stem cell donors undergo in-depth medical and sexual health questionnaires, and will have a face-to-face interview with donor centre staff, allowing ample opportunity to identify those donors at increased risk of contracting a window-period infection.

In many cases, the benefit to the recipient of receiving a donation will vastly outweigh the risk of transmission of an infectious agent. Therefore, this time period me be reduced at the discretion of the requesting transplant centre.

Epstein-Barr Virus

2018-11-26T17:39:39Z

MariaCuadrado: /* Guidance at Work-up */

==Condition==
Herpes virus causing glandular fever (infectious mononucleosis).

==Individual at risk==
Recipient (and ?donor)

==Guidance at RECRUITMENT==
ACCEPTABLE

==Guidance at CT==
ACCEPTABLE

==Guidance at Work-up==

The following serological tests should be obtained

• VCA-IgM

• VCA-IgG

• (EBNA-IgG)

===Outcomes and recommended actions based on EBV serology and PCR:===

'''Potential serology/PCR combinations:'''

1) '''VCA-IgM neg AND VCA-IgG pos or neg.

'''

''Donor can be cleared - transplant centre should be informed for serological/PCR status''

2) '''VCA-IgM-pos AND VCA-IgG and/or EBNA weak or negative
'''

a) Donor has no symptoms of viral infection* --> Inform the TC and proceed donation without EBV-DNA PCR if TC agrees. (Request EBV PCR if TC asks for it. Inform the TC with the result and act according to TC's preference)

b) Donor has symptoms of viral infection --> Request EBV DNA PCR.
- If EBV DNA PCR is positive --> inform TC and repeat PCR in 4-6 weeks
- If EBV DNA PCR is negative --> proceed with donation when donor's symptoms get better

*The clinical picture (e.g. sore throat, swollen lymph glands) as well as laboratory parameters (lymphocytosis, atypical lymphocytes on blood smear) should be correlated with serology, and taken into account for reasons of donor safety. Consider more specific immunoblots to validate the serology results. Results should be communicated with transplant centre.''

==Justification for guidance==
Primary EBV infection or reactivation in a transplant recipient is associated with post-transplant lymphoproliferative disease, amongst other morbidity.

==References==
Buisson, M., Fleurent, B., Mak, M., Morand, P., Chan, L., Ng, A., … Seigneurin, J. M. (1999). Novel Immunoblot Assay Using Four Recombinant Antigens for Diagnosis of Epstein-Barr Virus Primary Infection and Reactivation. Journal of Clinical Microbiology, 37(8), 2709–2714. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103296/]

APA Recommendations of the Center for International Blood and Marrow Transplant Research (CIBMTR®), the National Marrow Donor Program (NMDP), the European Blood and Marrow Transplant Group (EBMT), the American Society of Blood and Marrow Transplantation (ASBMT), the Canadian Blood and Marrow Transplant Group (CBMTG), the Infectious Disease Society of America (IDSA), the Society for Healthcare Epidemiology of America (SHEA), the Association of Medical Microbiology and Infectious Diseases Canada (AMMI), and the Centers for Disease Control and Prevention (CDC), Tomblyn, M., Chiller, T., Einsele, H., Gress, R., Sepkowitz, K., … Boeckh, M. A. (2009). Guidelines for Preventing Infectious Complications among Hematopoietic Cell Transplant Recipients: A Global Perspective. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 15(10), 1143–1238. doi:10.1016/j.bbmt.2009.06.019 [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC85323/]

==Version==
Version 2, Edition 1

====Date of Last Update====
3 March 2016