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2.
Cornea ; 41(12): 1559-1563, 2022 Dec 01.
Article in English | MEDLINE | ID: covidwho-2107628

ABSTRACT

PURPOSE: The aim of this study was to analyze the presence of the SARS-CoV-2 virus in the corneal tissue of asymptomatic deceased novel coronavirus disease 2019 (COVID-19) patients. METHODS: This was a cross-sectional study performed at a tertiary eye hospital. All corneas of the deceased asymptomatic donors who tested positive for SARS-CoV-2 on a nasopharyngeal swab at the time of corneal tissue harvesting were included in the study. Histopathological examination and immunohistochemistry were performed. mRNA in situ hybridization for SARS-CoV-2 was performed in all specimens that showed positive immunostaining. The main outcome measure was the presence of SARS-CoV-2 virus in the corneal tissues. RESULTS: Twenty-two corneal tissues of 11 donors were analyzed. The mean age was 72.2 ± 14.2 years. On histological examination, no signs of inflammation or any other abnormalities were detected in the cornea and adjacent bulbar conjunctiva. Immunohistochemistry revealed faint to moderate cytoplasmic staining in the basal layer of the corneal epithelium in 8 specimens from 5 patients. None of the specimens with positive immunostaining showed the presence of SARS-CoV-2 mRNA. CONCLUSIONS: In line with previous studies , our study also reflects the absence of SARS-CoV-2 viral mRNA in corneal tissues of clinically asymptomatic deceased COVID-19 donors, thereby indicating a probable low risk of transmission of the SARS-CoV-2 virus through the transplantation of corneas from donors who tested positive for, but were asymptomatic for COVID-19. In addition, further studies on the subject should include histopathological examination because of the false positive and negative rates of molecular tests.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Middle Aged , Aged , Aged, 80 and over , COVID-19/diagnosis , Cross-Sectional Studies , Tissue Donors , Cornea , RNA, Messenger/genetics
3.
Rev Esp Quimioter ; 35 Suppl 3: 54-62, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2091724

ABSTRACT

SARS-CoV-2 infection has had a major impact on donation and transplantation. Since the cessation of activity two years ago, the international medical community has rapidly generated evidence capable of sustaining and increasing this neccesary activity. This paper analyses the epidemiology and burden of COVID-19 in donation and transplantation, the pathogenesis of the infection and its relationship with graft-mediated transmission, the impact of vaccination on donation and transplantation, the evolution of donation in Spain throughout the pandemic, some lessons learned in SARS-CoV-2 infected donor recipients with positive PCR and the applicability of the main therapeutic tools recently approved for treatment among transplant recipients.


Subject(s)
COVID-19 , Organ Transplantation , Humans , SARS-CoV-2 , Pandemics , Tissue Donors
5.
Pediatr Transplant ; 26(8): e14407, 2022 12.
Article in English | MEDLINE | ID: covidwho-2052905

ABSTRACT

BACKGROUND: Amid a viral pandemic with poorly understood transmissibility and pathogenicity in the pediatric patient, we report the first pediatric liver transplants utilizing allografts from SARS-CoV-2+ donors. METHODS: We describe the outcomes of two pediatric liver transplant recipients who received organs from SARS-CoV-2 nucleic acid test-positive (NAT+) donors. Data were obtained through the respective electronic medical record system and UNet DonorNet platform. RESULTS: The first donor was a 3-year-old boy succumbing to head trauma. One of four nasopharyngeal (NP) swabs and 1 of 3 bronchoalveolar lavage (BAL) NAT tests demonstrated SARS-CoV-2 infection before organ procurement. The second donor was a 16-month-old boy with cardiopulmonary arrest of unknown etiology. Three NAT tests (2 NP swab/1 BAL) prior to procurement failed to detect SARS-CoV-2. The diagnosis was made when the medical examiner repeated 2 NP swab NATs and an archive plasma NAT, all positive for SARS-CoV-2. Both 2-year-old recipients continue to do well 8 months post-transplant, with excellent graft function and no evidence of SARS-CoV-2 transmission. CONCLUSIONS: This is the first report to describe successful pediatric liver transplantation from SARS-CoV-2+ donors. These data reinforce the adult transplant experience and support the judicious use of SARS-CoV-2+ donors for liver transplantation in children. With SARS-CoV-2 becoming endemic, the concern for donor-derived viral transmission must now be weighed against the realized benefit of life-saving transplantation in the pediatric population as we continue to work toward donor pool maximization.


Subject(s)
COVID-19 , Liver Transplantation , Humans , Child , Adult , Male , Infant , Child, Preschool , SARS-CoV-2 , Pandemics , Tissue Donors
7.
Cas Lek Cesk ; 161(3-4): 153-158, 2022.
Article in English | MEDLINE | ID: covidwho-2027003

ABSTRACT

Since time immemorial, bodies of deceased have been an integral part of teaching anatomy, and therefore the study of medicine. Without them, the teaching of anatomy, clinical anatomy and many research projects could not be realized. Nowadays, the European countries allow to use exclusively bodies of the deceased donors. Recently, we have registered a growing trend in the needs of the bodies not only for the purposes of medical education, but also for those of clinical anatomy. The question also arose of the suitability of using COVID-19 positive donors or the legislative possibility of obtaining bodies in the absence of donors in the donor program. Our communication addresses current issues of body donation for teaching and research purposes and their use in the Czech Republic.


Subject(s)
COVID-19 , Education, Medical , COVID-19/epidemiology , Czech Republic , Europe , Humans , Tissue Donors
8.
Anaesthesia ; 77(11): 1237-1250, 2022 11.
Article in English | MEDLINE | ID: covidwho-2029274

ABSTRACT

The COVID-19 pandemic had a major impact on UK deceased organ donation and transplantation activity. We used national audit data from NHS Blood and Transplant to explore in detail the effects of the pandemic in comparison with 12 months pre-pandemic, and to consider the impact of the mitigating strategies and challenges placed on ICU by 'waves' of patients with COVID-19. Between 11 March 2020 and 10 March 2021, referrals to NHS Blood and Transplant of potential organ donors were initially inversely related to the number of people with COVID-19 undergoing mechanical ventilation in intensive care (incident rate ratio (95%CI) per 1000 patients 0.93 (0.88-0.99), p = 0.018), although this pattern reversed during the second wave (additional incident rate ratio (95%CI) 1.12 (1.05-1.19), p < 0.001). Adjusted numbers of donors (incident rate ratio (95%CI) 0.71 (0.61-0.81), p < 0.001) and organs retrieved (incident rate ratio (95%CI) 0.89 (0.82-0.97), p = 0.007) were inversely dependent on COVID-19 workload, though weekly numbers of transplants were unrelated (incident rate ratio (95%CI) 0.95 (0.86-1.04), p = 0.235). Non-COVID-19 mortality fell from 15,007 to 14,087 during the first wave (rate ratio (95%CI) 0.94 (0.92-0.96), p < 0.001) but climbed from 18,907 to 19,372 during the second wave (rate ratio (95%CI) 1.02 (1.00-1.05), p = 0.018). There were fewer in-hospital deaths from cardiac arrest and intracranial catastrophes throughout (rate ratio (95%CI) 0.83 (0.81-0.86), p < 0.001 and rate ratio (95%CI) 0.88 (0.85-0.91), p < 0.001, respectively). There were overall fewer eligible donors (n = 4282) when compared with pre-pandemic levels (n = 6038); OR (95%CI) 0.58 (0.51-0.66), p < 0.001. The total number of donations during the year fell from 1620 to 1140 (rate ratio (95%CI) 0.70 (0.65-0.76), p < 0.001), but the proportion of eligible donors who proceeded to donation (27%) was unchanged (OR (95%CI) 0.99 (0.91-1.08), p = 0.821). The reduction in donations and transplantation during the pandemic was multifactorial, but these data highlight the impact in the UK of a fall in eligible donors and an inverse relationship of referrals to COVID-19 workload. Despite the challenges faced, the foundations underpinning the UK deceased organ donation programme remained strong.


Subject(s)
COVID-19 , Organ Transplantation , Tissue and Organ Procurement , COVID-19/epidemiology , Humans , Pandemics , Tissue Donors , United Kingdom/epidemiology
9.
11.
Indian J Ophthalmol ; 70(9): 3289-3293, 2022 09.
Article in English | MEDLINE | ID: covidwho-2024722

ABSTRACT

Purpose: To describe the causes and trends of corneal donor mortality from eye bank data in India during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This retrospective eye bank-based study included 13,529 donors who donated their cornea between January 2018 and December 2021. Donors in whom the cause of mortality was documented were included as cases. The data were collected from the eye bank records. Results: Overall, 13,529 corneal donors were included in the study. Most of the donors were males (69.71%). The mean age of the donors was 51.55 ± 20.54 years, whereas the median age was 51 (inter-quartile range: 35-68) years. The mean age of males (49.3 ± 19.47 years) was lesser than the mean age of females (56.72 ± 21.94 years) at the time of donation. The most common age group at the time of donation was during the sixth decade of life with 2,139 (15.81%) donors. The mean age of the donors decreased by a decade from 54.95 ± 20.51 years in 2018 to 44.35 ± 18.88 years in 2021. The most common cause of donor mortality was cardio-respiratory arrest in 5,190 (38.36%) donors and trauma in 3,469 (25.64%) donors, followed by suicide in 2,790 (20.62%) donors. The trend of cardio-respiratory arrest decreased from 53.01% to 9.5% (p = <0.00001), whereas the trends of trauma increased from 21.93% to 36% (p = <0.00001) and suicide increased from 12.71% to 36.41% (p = <0.00001) between 2018 and 2021. Conclusion: Corneal donors are more commonly males in their sixth decade of life. The most common cause of donor mortality was related to cardio-respiratory arrest with a concerning rising trend in suicide cases over the years seen significantly during the pandemic.


Subject(s)
COVID-19 , Corneal Transplantation , Tissue and Organ Procurement , Adult , Aged , Cornea , Eye Banks , Female , Humans , India , Male , Middle Aged , Pandemics , Retrospective Studies , Tissue Donors
13.
Orv Hetil ; 163(30): 1181-1188, 2022 Jul 24.
Article in English | MEDLINE | ID: covidwho-1997355

ABSTRACT

INTRODUCTION: The incidence of organ transplantation between the Eastern and Western part of Europe is quite different. This has several reasons; the main cause may be the Great Schism (A. D. 1054) when the Byzantine Empire separated himself also religiously from Rome. Since then there has been a different historical development followable until our days. Later on, disintegration of four previous large empires into many smaller countries during the last 150 years, furthermore in the second half of the twentieth century the separation by the Iron Curtain in the middle of Europe led to different social-economic and infrastructural developments between the different parts of the continent. In the new millennium, all transplantations for the routinely performed 5 organs were available for the Hungarian patients, but the real era-changing happened in 2012/13 by joining Eurotransplant. OBJECTIVE: Our analysis is based on the transplantation numbers of the last pre-COVID pandemic year (2019). RESULTS: The abovementioned differences can be traced well by the transplantation numbers: 28 Western- and Middle-European countries have 22.2 cadaveric donors per million population versus 3.8 for 10 Eastern-European countries and another 7 do not have any. The numbers of transplanted organs are the following: 39.5 vs. 12.0 for kidney; 14.8 vs. 5.5 for liver; 5.4 vs. 0.8 for heart; 4.6 vs. 0.2 for lung. DISCUSSION: The statistics have also a rejoicing message because since the fall of the Iron Curtain, 10 Middle-European countries could reach the Western standards in organ transplantation. Their example is also good news for other Eastern European countries. CONCLUSION: Hungary was one of these countries who could benefit from the political changes and, by joining Eurotransplant, the quantity and quality of the transplanted organs was raised significantly: since then, there are by 40% more transplantations performed in our country. Orv Hetil. 2022; 163(30): 1181-1188.


Subject(s)
COVID-19 , Organ Transplantation , Tissue and Organ Procurement , Humans , Hungary , Tissue Donors
14.
16.
Hum Immunol ; 83(11): 749-754, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1983137

ABSTRACT

The COVID-19 pandemic has led to significant morbidity and mortality in lung transplant recipients. Respiratory viral infections may be associated with de-novo HLA donor-specific antibody production and impact lung transplant outcome. Since one of the immunomodulation strategies post-SARS-CoV-2 infection in lung transplant recipients include decreasing or holding anti-metabolites, concerns have been raised for higher incidence of de-novo HLA donor specific antibody production in lung transplant recipients. We performed a retrospective chart review of 24 consecutive lung transplant recipients diagnosed with COVID-19 to investigate this concern. We observed no significant differences in the CPRA or MFI levels of HLA class I and II antibodies pre- COVID-19 compared to 1 and 6 months post-COVID-19 diagnosis in 11/24 (45.8 %) LTR (p = 0.98 and p = 0.63 respectively). HLA class I and II DSA were detected in 5/24 LTR pre-COVID-19 diagnosis and persisted with no significant differences in the median MFI levels at 1 and 6 months post-COVID-19 diagnosis (p = 0.89). De-novo HLA class I and II DSA were detected in 1/24 (4.2 %) LTR at one month post-COVID-19 diagnosis and persisted with no significant differences in the median MFI levels at 1 and 6 months post-COVID-19 diagnosis (p = 0.54). Our results suggest that there was no significant association between SARS-CoV-2 infection and immunomodulation on pre-existing or de novo HLA donor specific antibodies.


Subject(s)
COVID-19 , Transplant Recipients , Antibodies , Antibody Formation , COVID-19 Testing , Graft Rejection , Graft Survival , HLA Antigens , Humans , Isoantibodies , Lung , Pandemics , Retrospective Studies , SARS-CoV-2 , Tissue Donors
17.
Transpl Int ; 35: 10466, 2022.
Article in English | MEDLINE | ID: covidwho-1979081

ABSTRACT

Recently England and Netherlands have changed their consent system from Opt In to Opt Out. The reflections shared in this paper give insight and may be helpful for other nation considering likewise. Strong support in England for the change in legislation led to Opt Out being introduced without requiring a vote in parliament in 2019. In Netherlands the bill passed by the smallest possible majority in 2018. Both countries implemented a public campaign to raise awareness. In England registration on the Donor Register is voluntary. Registration was required in Netherlands for all residents 18 years and older. For those not already on the register, letters were sent by the Dutch Government to ask individuals to register. If people did not respond they would be legally registered as having "no objection." After implementation of Opt Out in England 42.3% is registered Opt In, 3.6% Opt Out, and 54.1% has no registration. In contrast in Netherlands the whole population is registered with 45% Opt In, 31% Opt Out and 24% "No Objection." It is too soon to draw conclusions about the impact on the consent rate and number of resulting organ donors. However, the first signs are positive.


Subject(s)
Tissue and Organ Procurement , England , Government , Humans , Netherlands , Tissue Donors
19.
Transpl Infect Dis ; 24(4): e13890, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1968201

ABSTRACT

OBJECTIVE: In this study, we aim to assess short-term allograft outcomes following deceased donor kidney transplantation from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lower respiratory tract (LRT) nucleic acid testing (NAT) positive donors. METHODS: From September to December 2021, SARS-CoV-2 NAT positive organ donors, whose solid abdominal organs were transplanted at our academic medical center were identified. Donors were stratified into having tested positive for SARS-CoV-2 in an upper respiratory tract (URT) or LRT sample. For this study, the SARS-CoV-2 LRT NAT positive deceased kidney donors and their respective recipients were examined. Donor and recipient demographic data, coronavirus disease 2019 (COVID-19)-related history, patient outcomes, as well as postoperative graft function were evaluated. RESULTS: Thirteen SARS-CoV-2 positive deceased donors were identified. Of these, eight were LRT NAT positive and yielded nine kidneys. These allografts were successfully transplanted into vaccinated and unvaccinated recipients. All recipients received standard induction immunosuppression and did not receive any prophylactic therapy for SARS-CoV-2. Two recipients had delayed graft function. At 1-month post-transplant, there was no clinical evidence of donor-derived COVID-19 or graft loss, and all recipients were free from dialysis. CONCLUSION: We describe the first case series of SARS-CoV-2 LRT NAT positive deceased kidney donors for vaccinated and unvaccinated recipients with excellent short-term allograft outcomes and no clinical evidence of donor-derived COVID-19 post-transplantation. Given the increasing prevalence of SARS-CoV-2 in the population, utilization of SARS-CoV-2 LRT NAT positive deceased donors could be considered an acceptable source of organs for renal transplantation, especially as multi-center experiences and longer-term follow-up emerge.


Subject(s)
COVID-19 , Kidney Transplantation , Humans , Kidney Transplantation/adverse effects , Respiratory System , SARS-CoV-2 , Tissue Donors
20.
J Heart Lung Transplant ; 41(10): 1382-1384, 2022 10.
Article in English | MEDLINE | ID: covidwho-1936471
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