Bulletin 22-7

AATB Physicians Council MPXV Recommendations

On August 15, a thorough review of Monkeypox Virus geared towards the tissue banking community (Physicians Council Provides Information on Monkeypox Virus (MPXV)), including a discussion of testing considerations, was published by AATB. Since that time, FDA published recommendations for HCT/P donors (see AATB Bulletin 22-6, FDA Considerations for Tissue Establishments Regarding Monkeypox Virus). 

AATB Physicians Council Recommendations for all tissue donors: 

Exclude donors with:

  • Positive results for monkeypox/orthopoxvirus by real-time polymerase chain reaction (RT-PCR) and/or sequencing in the last 21 days.
  • History in the last 21 days of suspected monkeypox virus infection (not fully diagnosed or lab results pending), direct human contact with confirmed MPX through sores/scabs or bodily fluids, indirect contact through fomites & respiratory secretions, or vertical contact through pregnancy. 
  • Contact in the last 21 days with an animal confirmed or suspected to have monkeypox.
  • Vaccination using the ACAM2000 replication-competent vaccinia virus vaccine within the preceding 8 weeks if the vaccination scab has not separated spontaneously or are less than 21 days post vaccination. There must be confirmation that there is no scab at the vaccination site. If the scab was removed before separation, exclude donors for 2 months after scab removal.  


  • Carefully consider those donors who present with unexplained fevers, chills, myalgias, headache, lymphadenopathy, back pain, extreme weakness, and/or vesicular and pustular eruptions including anogenital lesions.
    • Also carefully consider that donors may not have the entire constellation of usual monkeypox symptoms, and in the current outbreak rashes are not always extensive or easy to locate. 

Donor risk assessment questions that may be used to obtain information specific to screening for risk of Monkeypox Virus:

  • Was she/he told by a healthcare professional she/he was diagnosed with monkeypox, suspected of having monkeypox, or treated for monkeypox in the past 21 days? If yes:
    • When was she/he diagnosed?
    • Was testing performed? If yes, what were the results?
    • Have all scabs from the rash fallen off?
  • Was she/he told that she/he could have been exposed to human and/or animal Monkeypox Virus in the past 21 days? If yes,
    • Who told her/him?
    • When did the exposure occur?
  • Has she/he been vaccinated with monkeypox or smallpox vaccine in the past 6 months? If yes, 
    • When?
    • Which vaccine?
    • Why were they vaccinated?


Disclaimer: The selection of risk-mitigation criteria pertaining to MPX, which includes symptomatology, exposure, close contact, infection status, and testing for MPX, is in the sole discretion of the medical director of the tissue bank responsible for donor eligibility determination as long as the intent of relevant standards, e.g., D4.120, D4.150, F1.120 and Appendix II, is met.


If you have questions, please contact standards@aatb.org.