ABSTRACT
The unprecedented public health emergency caused by the acute viral respiratory coronavirus disease (COVID-19) has drastically changed current practices in solid organ transplantation, markedly so for transplantation of the lungs, the major target of the virus. Although national and state authorities do not recommend postponing transplant procedures, most specialists are reluctant to proceed due to substantial uncertainty and increased risks in the midst of the pandemic. There is an urgent need for evidence-based directions to move forward. Here, we offer our insights as specialists at a high-volume center located in a geographical area with high infection rates.
Subject(s)
COVID-19/prevention & control , Infection Control/methods , Lung Transplantation/methods , Perioperative Care/methods , Tissue and Organ Harvesting/methods , Tissue and Organ Procurement/methods , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Testing , Health Services Accessibility , Hospitals, High-Volume , Humans , Infection Control/trends , Lung Transplantation/trends , Pandemics , Perioperative Care/trends , Philadelphia/epidemiology , Postoperative Complications/diagnosis , Postoperative Complications/therapy , Tissue and Organ Harvesting/trends , Tissue and Organ Procurement/trendsABSTRACT
The COVID-19 pandemic has necessitated that operating room procedures be modified to ensure the safety of staff and patients. Specifically, procedures that have the potential to create aerosolization must be reassessed, given the risk of viral transmission via aerosolization. We present the use of a nonsealed endoscopic vessel harvesting approach during coronary surgery that does not necessitate the use of CO2 insufflation and utilizes suction through an ultra low particulate filter, thus mitigating the risk of possible viral transmission via aerosolization or surgical smoke production. This approach is technically feasible and can minimize the risk of viral transmission during endoscopic vessel harvesting.