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Recommendations on Personal Protective Equipment (PPE) for Tissue Bank Recovery and Processing Personnel

Bulletin 20-11

April 23, 2020

The Panel on COVID-19 formed by the AATB Physicians Council has issued the following:

SARS-CoV-2 has demonstrated the capability to spread rapidly, predominantly by respiratory route, but also potentially via contact surfaces, leading to significant impacts on healthcare systems and causing societal disruption. To respond effectively to the COVID-19 outbreak, appropriate clinical management and infection control in conjunction with implementation of community mitigation efforts are critical.[1] In tissue banking, deceased donors generally do not pose aerosolization risk because they are not speaking, coughing, or sneezing.

It is the intent of these recommendations to be practical and to consider the most appropriate PPE for tissue recovery, including when it is appropriate to use higher level personal protective equipment (PPE) (i.e. use of N-95 masks). N-95 masks require fit testing for optimization of intended use, and are not necessary for most tissue recovery operations.

Use of PPE in Tissue Recovery Operations and/or Processing

Universal and droplet precautions generally suffice for medical triage of possible COVID-19 cases, which should also be applied to tissue recovery and processing operations. This approach is consistent with the CDC recommendations for collecting specimens from deceased persons with COVID-19.

  • A traditional recovery of bone, soft tissue, skin, heart valves, ocular, and vascular tissues is reasonably handled with routine masks, gowns, eye protection, and shoe covers with underlying scrubs.
  • When electric oscillating saws are used, which may aerosolize and suspend viral particles during cutting of bone, PPE for aerosolizing procedures, including use of N-95 masks, should be used.
  • Following standard procedures, all PPE should be removed and either discarded or placed in the appropriate areas for cleaning and decontamination.
  • Any staff who has symptoms or an exposure to a known COVID-19 patient should discuss this issue with their healthcare provider and notify their manager so they can determine next steps with regard to the safety of other staff.
  • The medical director for each tissue establishment should educate staff using these recommendations along with published CDC guidelines and in alignment with their organizations policies. 
  • Questions regarding this bulletin should be submitted to Dr. Roman Hitchev at hitchevr@aatb.org.
 

[1]Enforcement Policy for Gowns, Other Apparel, and Gloves During the Coronavirus Disease (COVID-19) Public Health Emergency: Guidance for Industry and Food and Drug Administration Staff, March 2020, US Department of health and Human Services, Food and Drug Administration