2024-31538. Recommendations To Reduce the Risk of Transmission of Disease Agents Associated With Sepsis by Human Cells, Tissues, and Cellular and Tissue-Based Products; Guidance for Industry; Availability
-
AGENCY:
Food and Drug Administration, HHS.
ACTION:
Notice of availability.
SUMMARY:
The Food and Drug Administration (FDA, the Agency, or we) is announcing the availability of a final guidance for immediate implementation entitled “Recommendations To Reduce the Risk of Transmission of Disease Agents Associated with Sepsis by Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/Ps).” FDA is issuing this guidance to provide establishments making donor eligibility determinations with recommendations to reduce the risk of transmission of infections due to sepsis by HCT/Ps. This notice is being issued to respond to a public health safety concern and to address the urgent need for updated recommendations in making a donor eligibility determination when screening a donor for clinical evidence of sepsis and clinical signs to consider.
DATES:
The announcement of the guidance is published in the Federal Register on January 7, 2025.
ADDRESSES:
You may submit either electronic or written comments on Agency guidances at any time as follows:
Electronic Submissions
Submit electronic comments in the following way:
- Federal eRulemaking Portal: https://www.regulations.gov. Follow the ( print page 1142) instructions for submitting comments. Comments submitted electronically, including attachments, to https://www.regulations.gov will be posted to the docket unchanged. Because your comment will be made public, you are solely responsible for ensuring that your comment does not include any confidential information that you or a third party may not wish to be posted, such as medical information, your or anyone else's Social Security number, or confidential business information, such as a manufacturing process. Please note that if you include your name, contact information, or other information that identifies you in the body of your comments, that information will be posted on https://www.regulations.gov.
- If you want to submit a comment with confidential information that you do not wish to be made available to the public, submit the comment as a written/paper submission and in the manner detailed (see “Written/Paper Submissions” and “Instructions”).
Written/Paper Submissions
Submit written/paper submissions as follows:
- Mail/Hand Delivery/Courier (for written/paper submissions): Dockets Management Staff (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
- For written/paper comments submitted to the Dockets Management Staff, FDA will post your comment, as well as any attachments, except for information submitted, marked and identified, as confidential, if submitted as detailed in “Instructions.”
Instructions: All submissions received must include the Docket No. FDA-2024-D-3067 for “Recommendations To Reduce the Risk of Transmission of Disease Agents Associated with Sepsis by Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/Ps).” Received comments will be placed in the docket and, except for those submitted as “Confidential Submissions,” publicly viewable at https://www.regulations.gov or at the Dockets Management Staff between 9 a.m. and 4 p.m., Monday through Friday, 240-402-7500.
- Confidential Submissions—To submit a comment with confidential information that you do not wish to be made publicly available, submit your comments only as a written/paper submission. You should submit two copies total. One copy will include the information you claim to be confidential with a heading or cover note that states “THIS DOCUMENT CONTAINS CONFIDENTIAL INFORMATION.” The Agency will review this copy, including the claimed confidential information, in its consideration of comments. The second copy, which will have the claimed confidential information redacted/blacked out, will be available for public viewing and posted onhttps://www.regulations.gov. Submit both copies to the Dockets Management Staff. If you do not wish your name and contact information to be made publicly available, you can provide this information on the cover sheet and not in the body of your comments and you must identify this information as “confidential.” Any information marked as “confidential” will not be disclosed except in accordance with 21 CFR 10.20 and other applicable disclosure law. For more information about FDA's posting of comments to public dockets, see 80 FR 56469, September 18, 2015, or access the information at: https://www.govinfo.gov/content/pkg/FR-2015-09-18/pdf/2015-23389.pdf.
Docket: For access to the docket to read background documents or the electronic and written/paper comments received, go to https://www.regulations.gov and insert the docket number, found in brackets in the heading of this document, into the “Search” box and follow the prompts and/or go to the Dockets Management Staff, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852, 240-402-7500.
You may submit comments on any guidance at any time (see 21 CFR 10.115(g)(5)).
Submit written requests for single copies of the guidance to the Communication, Outreach and Development, Center for Biologics Evaluation and Research (CBER), Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 71, Rm. 3128, Silver Spring, MD 20993-0002. Send one self-addressed adhesive labels to assist that office in processing your requests. The guidance may also be obtained by mail by calling CBER at 1-800-835-4709 or 240-402-8010. See the SUPPLEMENTARY INFORMATION section for electronic access to the guidance document.
FOR FURTHER INFORMATION CONTACT:
Jessica Gillum, Center for Biologics Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 71, Rm. 7301, Silver Spring, MD 20993-0002, 240-402-7911.
SUPPLEMENTARY INFORMATION:
I. Background
FDA is announcing the availability of a final guidance for immediate implementation entitled “Recommendations To Reduce the Risk of Transmission of Disease Agents Associated with Sepsis by Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/Ps).”
FDA is issuing the guidance to provide establishments making donor eligibility determinations with recommendations to reduce the risk of transmission of disease agents associated with sepsis for donors of human cells, tissues, and cellular and tissue-based products. This guidance supersedes the information regarding sepsis in the August 2007 guidance entitled “Eligibility Determination for Donors of Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/Ps).” The August 2007 guidance identified sepsis as a relevant communicable disease agent or disease under 21 CFR 1271.3(r)(2).
Elsewhere in this issue of the Federal Register , FDA is announcing the availability of another guidance for immediate implementation entitled “Recommendations To Reduce the Risk of Transmission of Mycobacterium Tuberculosis (Mtb) by Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/Ps).” This guidance is being issued to assist establishments that make donor eligibility determinations for donors of human cells, tissues, and cellular and tissue-based products, with recommendations for screening donors for evidence of, and risk factors for, infection with Mtb, the organism that causes tuberculosis, which can be a cause of sepsis.
We are issuing this guidance consistent with our good guidance practices (GGP) regulation (§ 10.115 (21 CFR 10.115)). We are implementing this guidance without prior public comment because we have determined that prior public participation is not feasible or appropriate (§ 10.115(g)(2)). We made this determination because of the urgent need to update recommendations to industry for screening a donor for risk factors and conditions, and clinical and physical evidence, associated with the disease agents that cause sepsis. Although this guidance document is immediately in effect, it remains subject to comment in accordance with FDA's GGP regulation.
The guidance represents the current thinking of FDA on “Recommendations To Reduce the Risk of Transmission of Disease Agents Associated with Sepsis by Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/Ps).” It does not establish any rights for any person and is not binding on FDA or the public. You can use an alternative approach if it satisfies the requirements of the applicable statutes and regulations. ( print page 1143)
II. Paperwork Reduction Act of 1995
While this guidance contains no collection of information, it does refer to previously approved FDA collections of information. The previously approved collections of information are subject to review by the Office of Management and Budget (OMB) under the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C. 3501-3521). The collections of information in 21 CFR 1271 relating to HCT/Ps, including establishing and maintaining records, investigation and reporting of adverse actions and documentation of methods used in facilities related to HCT/Ps, which, includes but not limited to donor screening, donor testing, and labeling have been approved under OMB control number 0910-0543.
III. Electronic Access
Persons with access to the internet may obtain the guidance at https://www.fda.gov/vaccines-blood-biologics/guidance-compliance-regulatory-information-biologics/biologics-guidances, https://www.fda.gov/regulatory-information/search-fda-guidance-documents, or https://www.regulations.gov.
Dated: December 27, 2024.
Kimberlee Trzeciak,
Deputy Commissioner for Policy, Legislation, and International Affairs.
[FR Doc. 2024-31538 Filed 1-6-25; 8:45 am]
BILLING CODE 4164-01-P
Document Information
- Published:
- 01/07/2025
- Department:
- Food and Drug Administration
- Entry Type:
- Notice
- Action:
- Notice of availability.
- Document Number:
- 2024-31538
- Dates:
- The announcement of the guidance is published in the Federal Register on January 7, 2025.
- Pages:
- 1141-1143 (3 pages)
- Docket Numbers:
- Docket No. FDA-2024-D-3067
- PDF File:
- 2024-31538.pdf
- Supporting Documents:
- » Reference 27 - Antonov, D., et al., 2020, The Rash that Becomes Purpuric, Petechial, Hemorrhagic, or Ecchymotic, Clin Dermatol, 38(1): 3-18. doi: 10.1016/j.clindermatol.2019.07.
- » Reference 26 - Santistevan, J., et al., 2017, Rash Decisions: An Approach to Dangerous Rashes Based on Morphology, J Emerg Med, 52(4): 457-71. DOI: 10.1016/j.jemermed.2016.10.027.
- » Reference 25 - Lyon, M., Kaul, D., et al., for the Disease Transmission Advisory Committee (DTAC), Organ Procurement & Transplantation Network (OPTN). Infectious disease transmission from organ donors with meningitis or encephalitis. Abstract #572, 2011 American Transplant Congress, Philadelphia, PA.
- » Reference 24 - Basavaraju, SV., Kuehnert, MJ., Zaki, SR., Sejvar, JJ. Encephalitis caused by pathogens transmitted through organ transplants, United States, 2002-2013. Emerg Infect Dis. 2014 Sep;20(9):1443-51. doi: 10.3201/eid2009.131332.
- » Reference 23 - Organ Procurement & Transplantation Network (OPTN), Health Resources & Services Administration (HRSA). Guidance for Recognizing Central Nervous System Infections in Potential Deceased Organ Donors, What to Consider During Donor Evaluation and Organ Offers. https://optn.transplant.hrsa.gov/professionals/by-topic/guidance/guidance-for-recognizing-central-nervous
- » Reference 21 - Gando, S., et al., 2020, The SIRS Criteria Have Better Performance for Predicting Infection than qSOFA Scores in the Emergency Department, Nature Research, 10(1): 8095. doi: 10.1038/s41598-020-64314-8.
- » Reference 20 - Dugar, S., et al., 2020, Sepsis and Septic Shock: Guideline-Based Management, Cleveland Clinic J Med, 87(1): 53-64. https://www.ccjm.org/content/87/1/53.
- » Reference 18 - Donnelly JP, Locke JE, MacLennan PA, et al., Inpatient Mortality Among Solid Organ Transplant Recipients Hospitalized for Sepsis and Severe Sepsis. Clin Infect Dis 2016; 63:186.
- » Reference 17 - Fishman J., Grossi P. Donor-derived infection—the challenge for transplant safety. Nat Rev Nephrol 10, 663–672 (2014).
- » Reference 16 - Infection in the solid organ transplant recipients. Fishman JA. https://www.uptodate.com/contents/infection-in-the-solid-organ-transplant-recipient (accessed August 31, 2023).