ABSTRACT
Purpose: The coronavirus disease 2019 (COVID-19) pandemic has challenged many aspects of healthcare, including organ donation and transplantation. The purpose of this study is to demonstrate that utilization of COVID-positive organs can be carried out safely. Method(s): De-identified data from 569 organ donors processed through an organ procurement organization (OPO) from March 24, 2020, through September 30, 2021, was collected from the OPO's database and retrospectively analyzed. Demographics, clinical measures, transplant numbers, and outcomes were recorded. Result(s): 25 COVID-positive (study) and 544 COVID-negative (control) organ donors were analyzed. There was no significant difference between the mean ages of the study group (43.12+/-11.08, p = 0.665) and the control group (44.15+/-17.94, p = 0.665). The COVID-positive group achieved donor management goals at a significantly lower rate than the COVID-negative group (4.0% vs 48.7%, p = 0.000012). The COVID-positive group required significantly more continuous renal replacement therapy (16.0% vs 1.8%, p < 0.00001), and extracorporeal membrane oxygenation (24.0% vs 0.7%, p < 0.00001). Significantly fewer organs were transplanted from the COVID-positive donors (1.12+/-1.013, p < 0.00001) than from the COVIDnegative donors (2.56+/-1.671, p < 0.00001). The mean observed to expected ratio for the study group (0.5372+/-0.47434, p < 0.00001) was significantly lower than that of the control group (0.9489+/-0.55041, p < 0.00001). The study group donors were significantly more likely to be categorized as donation after circulatory death (DCD) donors (96.0% vs 27.8%, p < 0.00001). There was no significant difference between the groups regarding delayed graft function in the recipient (18.2% vs 26.8%, p = 0.522561) nor regarding the need for dialysis post-transplant (9.1% vs 11.6%, p = 0.795292). Conclusion(s): Fewer organs from COVID-positive donors were utilized for transplantation than organs from COVID-negative donors over the study period. COVID-positive organs have been of no detriment to recipients, as there is no evidence of increased delayed graft function nor the need for dialysis. Though no short-term COVID-19 transmission has been identified, we will continue to monitor for this and to track non-renal transplant outcomes. A larger multi-center study is warranted to further delineate the safety and efficacy of implementing protocols to utilize these organs.