ABSTRACT
COVID has drastically impacted organ donation across the world, leading to untold misery for thousands of patients who have been waiting for organs. Early rules on the use of organs from COVID positive or affected donors were stringent due to the fear of spread of disease or thrombotic complications in patients who received these organs. However much has changed in the past two years. Most of our adult population has either been infected with COVID, or has received two doses of vaccine, or both. The current variant, despite being more infective, is associated with mild disease, especially in those who have been vaccinated Our armamentarium against severe COVID has improved dramatically in the past year- we have effective vaccines, monoclonal antibodies for treatment of mild COVID in high risk patients and post exposure and antiviral prophylaxis and treatment which can substantially reduce the risk of severe COVID requiring ICU admission. The risk of transmission of COVID infection has to be balanced against the risk of patients dying with end organ disease. We will have to learn to live with COVID- this also means investigating whether organs from donors who are, or have been COVID positive can be used with acceptable risk -benefit in selected patients with end stage organ failure. This document is a summary of evidence and information regarding donor screening for SARS-CoV-2 and considerations for organ acceptance from donors with a history of COVID-19.
ABSTRACT
Background: Till date, more than 49 million people have been affected by COVID 19. There are special concerns with regards to myasthenia gravis (MG) patients one is immune suppression increasing their susceptibility to infection and second infections exacerbating MG. We describe our experience with 17 MG patients who had COVID 19 and their outcomes. Methods: Seventeen patients with MG who developed COVID 19 were identified from our database at Houston Methodist Hospital. Results: Out of the 17, 15 patients had generalized MG and 2 patients had ocular MG. Twelve patients (70%) were hospitalized. Four patients (23%) died. Four patients recovered with residual COVID 19 related complications. Nine of the patients were on more than one immune suppressant medication. Seven patients (41%) had MG exacerbation. The type of immune suppressants and steroids did not seem to affect outcomes of COVID 19. Patients treated with intravenous immunoglobulin for MG exacerbation had variable COVID 19 outcomes. Results: In our case series, 6 patients experienced MG exacerbation. The outcomes with relation to COVID 19 were variable and being on immune suppressants did not confer any benefit. The outcomes were not affected by the type of immune suppression.
ABSTRACT
The National Organ and Tissue Transplant Organization (NOTTO) has previously published transplant-specific guidelines with reference to COVID-19.([1]) The mortality is higher in dialysis patients with COVID-19 (12%-30%) than posttransplant COVID-19 patients (11.3%) and both are higher than the general population (<2%) in India.([2-5]) With the resumption of the kidney transplant program in various parts of India, new issues are expected to occur. There is uncertainty, regarding the safety of performing kidney,([ 6-8]) liver,([9-12]) and lunge([13]) transplantation in a recipient recently recovered from COVID-19. At present, we have limited evidence-based information about safety and feasibility of kidney transplantation from living donors, who have recovered from COVID-19.([4]) Recently, Indian Multi-center cohort studies have reported successful kidney transplantation in recipients from living donors with a previous diagnosis of COVID-19.([15, 16])
ABSTRACT
In December 2019, novel coronavirus (SARS-CoV-2) infection started in Wuhan and resulted in a pandemic within a few weeks' time. Organ transplant recipients being at a risk for more severe COVID-19 if they get SARS CoV-2 viral infection, COVID-19 vaccine has a significant role in these patients. The vaccine is a safer way to help build protection and would either prevent COVID-19 infection or at least diminish the severity of the disease. It would also reduce the risk of the continuing transmission and enhance herd immunity. Immuno-compromised patients should not receive live vaccines as they can cause vaccine-related disease and hence the guidelines suggest that all transplant recipients should receive age-appropriate 'inactivated vaccine' as recommended for general population. Though trials have not been undertaken on transplant recipients, efficacy and safety of COVID-19 vaccine have been scientifically documented for few vaccines among the general population.
ABSTRACT
In December 2019 Novel corona virus (SARS-CoV-2) infection started in Wuhan and resulted in a pandemic within few weeks' time. Organ transplant recipients being at a risk for more severe COVID-19 if they get SARS CoV-2 viral infection, COVID 19 Vaccine has a significant role in these patients. The vaccine is a safer way to help build protection and would either prevent COVID -19 infection or atleast diminish the severity of the disease. It would also reduce the risk of the continuing transmission and enhance herd immunity. Immuno compromised patients should not receive live vaccines as they can cause vaccine related disease and hence the guidelines suggest that all transplant recipients should receive age appropriate 'inactivated vaccine' as recommended for general population. Though trials have not been undertaken on transplant recipients, efficacy and safety of COVID-19 vaccine have been scientifically documented for few vaccines among the general population. © 2021 Indian Journal of Transplantation ;Published by Wolters Kluwer - Medknow.