Malaria - Tissue - Live Donors

Essential information

Definition/s

Resident: a donor who has ever been present in a malaria risk area (or areas), for a continuous period of 6 months or more (at any point in their lifetime).

Visitor: a donor who has visited or travelled through a malaria risk area (or areas) within the past 12 months.

Unexplained febrile illness: a donor who had undiagnosed fever (that could have been malaria) while present in, or within four months of leaving, a malaria risk area.

Previous diagnosis of malaria: a donor who previously had a confirmed diagnosis of malaria, at any point in their lifetime.

Malaria risk area: risk area for country as defined by the GDRI.

MAT: Malarial Antibody Test.

NAT: Nucleic Acid Test (for malaria).

Obligatory
  1. Must not donate (if no testing is available):
    Applies to all groups as defined above.
  2. Must not donate if testing is performed less than 4 months since:
    1. Anti-malaria therapy has been completed and symptoms caused by malaria have resolved, or
    2. Recovery of symptoms of unexplained febrile illness that could have been malaria, or
    3. Last present in a malaria risk area (or areas), or
    4. Since return from a malaria risk area (or areas).
Discretionary

1a. Previous malaria:

  • If more than 4 months have passed since anti-malaria therapy has been completed and symptoms caused by malaria have resolved, obtain a blood sample for MAT and NAT test. See information below in this section.

1b. Unexplained febrile illness:

  • If more than 4 months from the date of recovery of symptoms of unexplained febrile illness that could have been malaria: Obtain a blood sample for MAT and NAT. If MAT negative, NAT is not required to release tissues. See information below in this section.

1c. Resident:

  • If more than 4 months since date last present in a malaria risk area: Obtain a blood sample for MAT and NAT. If MAT negative, NAT is not required to release tissues. See information below in this section.

1d. Visitor:

  • If more than 4 and less than 12 months since return: Obtain a blood sample for MAT and NAT. If MAT negative, NAT is not required to release tissues. See information below in this section.
  • If more than 12 months since return: testing not required, accept.

Please note: consider T. cruzi or a tropical virus risk if the area is also identified as a risk area for these infections.

The results of MAT and NAT tests must be reviewed as a part of donor medical clearance to determine the suitability of tissues for clinical use. If the exposure, or, for donors with a history of malaria where treatment was completed and symptoms have resolved, was more than four months prior to donation and MAT is negative, NAT is not required. However, if MAT is positive and NAT is negative, in these donors, a risk assessment can be performed for accepting tissues for clinical release after seeking expert opinion.

2. If tissue will be sterilised by irradiation post-donation:

  • Accept. MAT and NAT testing is not required.

Supporting information

See if relevant
Additional information

Symptoms and signs of possible malaria include: fever, flu-like illness, (including shaking chills, headache, muscle aches, and tiredness), anaemia, jaundice, nausea, vomiting, diarrhoea and cough.

SaBTO Guidance confirms that irradiation of the tissue can be allowed as an alternative to malarial antibody testing.

Some countries have malaria as well as tropical viral risk. Both risks have to be considered if the donor had symptoms after travel or stay.

Reason for change:
This guidance was updated based on advice from the SACTTI parasitology sub-group.
Version details:

TL-DSG Edition 203 Release 52 (12 April 2023)