ABSTRACT
An algorithm was developed to assess COVID-positive donors. To assess effectiveness of this screening process, we reviewed our single center experience in both heart and lung transplant recipients. We reviewed 13 heart transplant (HT) and 9 lung transplant (LT) recipients who received an organ from a COVID-positive donor between 2/21 and 8/22 and were followed for 90 days. An algorithm consisting of 4 clinical scenarios was developed to aid donor offer review (see figure). COVID PCR testing was performed by nasopharyngeal swab. BAL specimen was required for lung donors. Donors with COVID PCR CT < 25 were declined, CT of 25-35 required joint clinical interpretation with transplant infectious disease, and CT > 35 were considered for transplant. Endpoints: COVID infection by 30 days, survival at 90 days, non-fatal major adverse cardiac events (NF-MACE;myocardial infarction, heart failure, percutaneous intervention, stroke) within 90 days for HT, rejection at 90 days, and severe PGD. All COVID-positive HT donors were scenario 3. No recipient and no staff involved in procurement acquired COVID 19 infection post-HT. Within 90 days post-HT, no patient experienced NF-MACE, 1 patient developed pAMR 2, 2 patients experienced severe PGD requiring VA-ECMO, and 1 patient experienced profound bleeding requiring VA ECMO and died 5 months post-HT of pulmonary embolism. For LT recipients, COVID-positive donors were scenario 1 (1), scenario 2(2) and scenario 3(6). All recipients received bilateral LT and no deaths occurred. Within 30 days post-LT, no patient or staff developed COVID infection, 2 recipients developed PGD (3 needing re-intubation), and 2 patients with A1 cellular rejection. No strokes were observed. Utilizing our program's COVID-19 donor algorithm, the use of heart and lung COVID-19 positive donors appears safe. Transplantation of thoracic organs is possible in COVID-19 positive donors with low titer, non-COVID related cause of death and no COVID related clinical complications. [ABSTRACT FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)