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1.
JAMA Netw Open ; 5(10): e2234874, 2022 10 03.
Article in English | MEDLINE | ID: covidwho-2059197

ABSTRACT

This cohort study investigates the association between the COVID-19 pandemic and waiting list times among pediatric heart transplant recipients in the US.


Subject(s)
COVID-19 , Heart Transplantation , Tissue and Organ Procurement , Child , Humans , Pandemics , Waiting Lists
2.
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
4.
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
5.
Exp Clin Transplant ; 20(Suppl 4): 88-91, 2022 08.
Article in English | MEDLINE | ID: covidwho-2010471

ABSTRACT

OBJECTIVES: The COVID-19 pandemic led to a decline in donation and transplant programs worldwide. Telehealth was explored as a strategy to continue organ procurement activity. The aim of this project was to develop and test I-DTI, an online medical platform for health care professionals specialized in the field of organ donation and transplant, that provides second-opinion consultancy and instant-messaging services. MATERIALS AND METHODS: The Donation and Transplantation Institute (DTI Foundation), in collaboration with the developers of an operative communication engine (Medxat/Be-Hit), designed the I-DTI platform, via a web-based application. I-DTI contents were created by the DTI Foundation medical team and international experts in organ donation and transplantation. I-DTI was launched in 2020 in a 6-month pilot phase, in which hospitals from India (Kerala), Philippines, Trinidad and Tobago, and Sri Lanka were included. In the pilot phase, about 60 health care professionals were involved and >20 international experts were enrolled to respond to incoming inquiries. The following topics were considered for this review: organ donation, organ transplantation, transplant follow-up, tissue donation, and COVID-19. Data collected were entered anonymously into an encrypted database for academic purposes. A survey was then conducted for all users to improve its acceptance and feasibility. RESULTS: On average, the second-opinion service was consulted 2 times per week by the participants, and experts' opinions were delivered in <24 hours. An intuitive user interface led participants to use the messaging service daily. Active dissemination contributed to I-DTI growth, achieving 300 users from >20 countries within the first year. CONCLUSIONS: I-DTI has proved to be a feasible tool to support health care professionals, for knowledge exchange and communication, ensuring access to international best practices. Nevertheless, it is imperative that medical providers actively encourage the use of innovative solutions available, especially in the areas with restricted access to knowledge.


Subject(s)
COVID-19 , Organ Transplantation , Tissue and Organ Procurement , Health Personnel , Humans , Pandemics , Treatment Outcome
6.
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
8.
Soc Sci Med ; 310: 115243, 2022 10.
Article in English | MEDLINE | ID: covidwho-1984060

ABSTRACT

BACKGROUND: Transplant rates in Ontario rose steeply in the decade prior to the COVID-19 pandemic. Reasons for that increase remain unclear, but the inter-organizational arrangement of organ donation programs may have contributed. However, there is a paucity of literature investigating these inter-organizational arrangements, with a limited understanding of how communication facilitates organ donation. Understanding these arrangements may help to re-establish rising organ donation rates post-pandemic. OBJECTIVE: To describe interprofessional interactions of Organ and Tissue Donation Coordinators (OTDCs) during organ donation cases, within organ donation programs in Ontario, from an organizational perspective (describing structure, context, process). METHODS: Mixed-method social network analysis (SNA) approach analyzing 14 organ donation cases just before the COVID-19 pandemic. RESULTS: Structure: Social network graphs depict the joint work performed by hospital staff and OTDCs, with a great part of the communication being processed through the OTDC. CONTEXT: Network density ranged from 0.05 to 0.24 across cases, and health care professionals perceived an atmosphere of shared vision and trust among team members. PROCESS: Most networks had a degree centralization <0.50 suggesting a decentralized information flow, and participants perceived decisions being jointly made. The characteristic path length of cases ranged from 1.6 to 3.2, suggesting potential for rapid information diffusion. Overall, data reinforced the OTDC role of intermediator within the communication process, and hospital staff perceived OTDCs as central players. Hospital staff and OTDCs reported frustration with some aspects of the flow of information during the organ allocation processes. CONCLUSION: Findings from this study provide a network map of communications within organ donation cases and reinforce the importance of the OTDC role. Opportunities for quality improvement within these processes are identified.


Subject(s)
COVID-19 , Tissue and Organ Procurement , COVID-19/epidemiology , Humans , Ontario , Pandemics , Personnel, Hospital , Social Network Analysis
9.
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
10.
Int. j. morphol ; 40(3): 801-807, jun. 2022.
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1969607

ABSTRACT

SUMMARY: During the Covid-19 pandemic that has marked the last years, while governments tried to control the spread of the virus, many-body donation programs were suspended due to difficulties that could potentially be encountered. Given the low body donation acceptance rates during this period, through this study we aimed to evaluate academics' knowledge, attitudes, and behaviors in cadaver acceptance and embalming practices during the pandemic. The research population of th estudy consisted of the faculty of 112 universities in Turkey who taught in under graduate and graduate programs in the Anatomy Department in 2020. An electronic questionnaire of 24 items, including demographic data, was distributed to the participants' official e-mail addresses. In addition, support was received from the Turkish Anatomy and Clinical Anatomy Society, whose members were also approached through their official group e-mail accounts. Answers were collected from 78 (39 %) out of 200 academics. The findings of the study were under 5 headings (ınformation about cadaver donation and ımported cadavers, attitude towards ımportation of cadavers and acceptance of body donations, precautions against contagion in ımportation of cadavers and acceptance of body donations and thoughts on their adequacy, considerations for adoption of cadavers for post-graduation education, advice on avoiding contagion in cadaver embalming) were collected and analyzed. The study high lights the importance of cadaver acceptance and embalming practices for medical education to minimally continue in the post-pandemic period. It can also serve as a reference for being cautious when faced with similar situations in the future.


RESUMEN: Durante la pandemia de COVID-19, que ha marcado los últimos años, mientras los gobiernos intentaban controlar la propagación del virus, muchos programas de donación de cuerpos fueron suspendidos por las dificultades que se podían encontrar. Dadas las bajas tasas de aceptación de la donación de cuerpos durante este período, a través de este estudio buscamos evaluar el conocimiento, las actitudes y los comportamientos de los académicos en la aceptación de cadáveres y las prácticas de embalsamamiento durante la pandemia. El estudio se realizó el año 2020 en los programas de pregrado y posgrado de los Departamentos de Anatomía de 112 universidades de Turquía. Se distribuyó un cuestionario electrónico de 24 ítems, incluidos datos demográficos, a los participantes por correo electrónico oficial. Además, se recibió el apoyo de la Sociedad Turca de Anatomía y Anatomía Clínica, cuyos miembros también fueron contactados a través de las cuentas de correo electrónico de su grupo oficial. Se recopilaron respuestas de 78 (39 %) de 200 académicos. Los hallazgos del estudio se ubicaron en 5 encabezados (información sobre donación de cadáveres y cadáveres importados, actitud hacia la importación de cadáveres y aceptación de donaciones de cuerpos, precauciones contra el contagio en la importación de cadáveres y aceptación de donaciones de cuerpos y opiniones sobre su idoneidad, consideraciones para la adopción de cadáveres para la educación de posgrado y consejos para evitar el contagio en el embalsamamiento de cadáveres). El estudio destaca la importancia de la aceptación de cadáveres y las prácticas de embalsamamiento para que la educación médica continúe mínimamente en el período posterior a la pandemia. También puede servir como referencia para tenerse presente ante situaciones similares en el futuro.


Subject(s)
Humans , Male , Female , Adult , Cadaver , Health Knowledge, Attitudes, Practice , Human Body , Faculty/psychology , COVID-19 , Anatomy/education , Turkey , Tissue and Organ Procurement , Surveys and Questionnaires , Embalming , Anatomists/psychology , Pandemics
11.
Camb Q Healthc Ethics ; 31(3): 355-367, 2022 07.
Article in English | MEDLINE | ID: covidwho-1960189

ABSTRACT

The genetic modification of pigs as a source of transplantable organs is one of several possible solutions to the chronic organ shortage. This paper describes existing ethical tensions in xenotransplantation (XTx) that argue against pursuing it. Recommendations for lifelong infectious disease surveillance and notification of close contacts of recipients are in tension with the rights of human research subjects. Parental/guardian consent for pediatric xenograft recipients is in tension with a child's right to an open future. Individual consent to transplant is in tension with public health threats that include zoonotic diseases. XTx amplifies concerns about justice in organ transplantation and could exacerbate existing inequities. The prevention of infectious disease in source animals is in tension with the best practices of animal care and animal welfare, requiring isolation, ethologically inappropriate housing, and invasive reproductive procedures that would severely impact the well-being of intelligent social creatures like pigs.


Subject(s)
Organ Transplantation , Tissue and Organ Procurement , Animal Welfare , Animals , Child , Ethics, Medical , Humans , Swine , Transplantation, Heterologous
12.
Camb Q Healthc Ethics ; 31(3): 368-378, 2022 07.
Article in English | MEDLINE | ID: covidwho-1960188

ABSTRACT

Organ trafficking in all its various forms is an international crime which could be entirely eliminated if healthcare professionals refused to participate in or be complicit with it. Types of organ trafficking are defined and principal international declarations and resolutions concerning it are discussed. The evidence for the involvement of healthcare professionals is illustrated with examples from South Africa and China. The ways in which healthcare professionals directly or indirectly perpetuate illegal organ transplantation are then considered, including lack of awareness, the paucity of both undergraduate and postgraduate education on organ trafficking, turning a blind eye, advocacy of organ commercialism, and the lure of financial gain.


Subject(s)
Organ Trafficking , Organ Transplantation , Tissue and Organ Procurement , China , Crime , Health Personnel , Humans
13.
J Heart Lung Transplant ; 41(10): 1382-1384, 2022 10.
Article in English | MEDLINE | ID: covidwho-1936471
14.
Am J Transplant ; 22(7): 1852-1860, 2022 07.
Article in English | MEDLINE | ID: covidwho-1937907

ABSTRACT

Despite the benefits of abdominal normothermic regional perfusion (A-NRP) for abdominal grafts in controlled donation after circulatory death (cDCD), there is limited information on the effect of A-NRP on the quality of the cDCD lungs. We aimed to study the effect of A-NRP in lungs obtained from cDCD and its impact on recipients´ outcomes. This is a study comparing outcomes of lung transplants (LT) from cDCD donors (September 2014 to December 2021) obtained using A-NRP as the abdominal preservation method. As controls, all lung recipients transplanted from donors after brain death (DBD) were considered. The primary outcomes were lung recipient 3-month, 1-year, and 5-year survival. A total of 269 LT were performed (60 cDCD and 209 DBD). There was no difference in survival at 3 months (98.3% cDCD vs. 93.7% DBD), 1 year (90.9% vs. 87.2%), and 5 years (68.7% vs. 69%). LT from the cDCD group had a higher rate of primary graft dysfunction grade 3 at 72 h (10% vs. 3.4%; p <  .001). This is the largest experience ever reported with the use of A-NRP combined with lung retrieval in cDCD donors. This combined method is safe for lung grafts presenting short-term survival outcomes equivalent to those transplanted through DBD.


Subject(s)
Liver Transplantation , Lung Transplantation , Tissue and Organ Procurement , Brain Death , Death , Graft Survival , Humans , Liver Transplantation/methods , Organ Preservation/methods , Perfusion/methods , Retrospective Studies , Tissue Donors
15.
Transplant Proc ; 54(5): 1212-1214, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1931144

ABSTRACT

BACKGROUND: COVID-19 has spread worldwide and has become a public health emergency and a pandemic of international concern. The solid organ donation system was no different. This study aimed to investigate the effect of COVID-19 on the liver transplant (LT) system in Brazilian territory. METHODS: We retrospectively reviewed all liver donor records allocated in São Paulo State, Brazil, 1 year before and 1 year during the COVID-19 pandemic. We defined the pre-COVID-19 (PRE) period as between April 2019 and April 2020 and the post-COVID-19 (POST) period as between April 2020 and April 2021. Moreover, we compared LT performed in our institution during these periods. To evaluate outcomes, we compared 30-day survival after LT. RESULTS: In the PRE period, 1452 livers were offered for donation in São Paulo State and other Brazilian territories. Of these, 592 were used in LT. In the POST period, 1314 livers were offered for donation, but only 477 were used in LT. Organ refusal was higher in the POST period (P < .05). Our center performed 127 and 156 LTs in these periods, respectively, and an increase above 20% was significant (P = .039). There was no difference in 30-day survival between the periods (87.2% vs 87.9%, P > .5, respectively). CONCLUSIONS: The COVID-19 pandemic harmed potential and allocated donors and LTs performed. However, it is possible to maintain the LT volume of a transplant center without compromising survival outcomes through preventive strategies against COVID-19 propagation.


Subject(s)
COVID-19 , Tissue and Organ Procurement , Brazil/epidemiology , COVID-19/epidemiology , Humans , Liver , Pandemics , Retrospective Studies , Tissue Donors
16.
Am J Transplant ; 22(9): 2203-2216, 2022 09.
Article in English | MEDLINE | ID: covidwho-1927554

ABSTRACT

The COVID-19 pandemic has influenced organ transplantation decision making. Opinions regarding the utilization of coronavirus disease-2019 (COVID-19) donors are mixed. We hypothesize that COVID-19 infection of deceased solid organ transplant donors does not affect recipient survival. All deceased solid organ transplant donors with COVID-19 testing results from March 15, 2020 to September 30, 2021 were identified in the OPTN database. Donors were matched to recipients and stratified by the COVID-19 test result. Outcomes were assessed between groups. COVID-19 test results were available for 17 694 donors; 150 were positive. A total of 269 organs were transplanted from these donors, including 187 kidneys, 57 livers, 18 hearts, 5 kidney-pancreases, and 2 lungs. The median time from COVID-19 testing to organ recovery was 4 days for positive and 3 days for negative donors. Of these, there were 8 graft failures (3.0%) and 5 deaths (1.9%). Survival of patients receiving grafts from COVID-19-positive donors is equivalent to those receiving grafts from COVID-19-negative donors (30-day patient survival = 99.2% COVID-19 positive; 98.6% COVID-19 negative). Solid organ transplantation using deceased donors with positive COVID-19 results does not negatively affect early patient survival, though little information regarding donor COVID-19 organ involvement is known. While transplantation is feasible, more information regarding COVID-19-positive donor selection is needed.


Subject(s)
COVID-19 , Organ Transplantation , Tissue and Organ Procurement , COVID-19/epidemiology , COVID-19 Testing , Graft Survival , Humans , Pandemics , Tissue Donors
17.
Clin Nephrol ; 98(1): 54-61, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1918020

ABSTRACT

BACKGROUND: Transplanting kidneys from donors with a recent history of severe SARS-CoV-2 pneumonia is uncommon due to concerns about the risk of viral transmission and the quality of kidneys from these donors. To date, there are no conclusive data on viral transmission from extrapulmonary solid organ transplants. Given the prevalence of SARS-CoV-2 infections in potential donors, shortage of kidneys available for transplantation, and low risk of viral transmission, we developed a clinical protocol for accepting kidneys from donors with recent severe SARS-CoV-2 pneumonia who demonstrate preserved kidney function. MATERIALS AND METHODS: We collected data on early outcomes of 5 kidney transplant recipients from 4 deceased donors hospitalized for severe SARS-CoV-2 infection. RESULTS: Donor creatinine ranged from 0.51 to 0.60 mg/dL and kidney donor profile index (KDPI) from 14 to 52%. Three of the five kidneys were from donation after circulatory death. All recipients were fully vaccinated, and 4/5 received post-exposure prophylactic monoclonal antibody treatment. While 3 recipients had delayed graft function, all had excellent graft function at 3 or 4 weeks post-operatively. None of the recipients displayed signs or symptoms of SARS-CoV-2 infection post-transplant. CONCLUSION: Our findings suggest that kidney grafts from donors with a recent history of severe SARS-CoV-2 infection but with preserved kidney function can be safely used and have good early outcomes.


Subject(s)
COVID-19 , Kidney Transplantation , Tissue and Organ Procurement , COVID-19/epidemiology , Graft Survival , Humans , Kidney Transplantation/adverse effects , Kidney Transplantation/methods , SARS-CoV-2 , Tissue Donors , Transplant Recipients
18.
19.
J Hepatol ; 77(4): 1198-1204, 2022 10.
Article in English | MEDLINE | ID: covidwho-1914597

ABSTRACT

The COVID-19 pandemic has significantly changed organ donation and transplantation worldwide. Since the beginning of the pandemic, the uncertainty regarding the potential route of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created tremendous pressures on transplantation communities, and international organisations have advised against using organs from deceased donors who have tested positive for SARS-CoV-2. The possibility of SARS-CoV-2 transmission through organ donation has only been reported for lung transplantation; hence, based on current experience, transplantation of non-lung organs from donors with active SARS-CoV-2 infection has been considered possible and safe, at least over short-term follow-up. As the evolving outbreak of SARS-CoV-2 continues, alongside the presence of vaccines and new treatment options, clinicians should consider transplanting organs from deceased donors with active SARS-CoV-2 infection to recipients with limited opportunities for transplantation and those with specific natural or vaccine-induced immunity. This article proffers an expert opinion on the use of organs from deceased donors with resolved or active SARS-CoV-2 infection in the absence of more definitive data and standardised acceptance patterns.


Subject(s)
COVID-19 , Organ Transplantation , Tissue and Organ Procurement , COVID-19/epidemiology , Humans , Organ Transplantation/adverse effects , Pandemics/prevention & control , SARS-CoV-2 , Tissue Donors
20.
J Heart Lung Transplant ; 41(10): 1376-1381, 2022 10.
Article in English | MEDLINE | ID: covidwho-1914428

ABSTRACT

We present our institution's protocol for evaluating and transplanting thoracic organs from COVID-19 positive donors and report the outcomes to date. Hearts from donors testing positive for COVID-19 on any test were eligible for transplantation at our institution provided the donor exhibited no evidence of hypercoagulability or COVID-19 induced hyperinflammatory state during terminal hospitalization. Lungs were eligible if the donor first tested PCR positive on nasopharyngeal swab (NPS) for COVID-19 > 20 days prior to procurement and had a negative lower respiratory tract specimen. We performed 14 thoracic transplants in 13 recipients using organs from COVID-19 positive donors. None of the recipients or healthcare members acquired COVID-19. No recipients suffered unexpected acute rejection. Patient survival is 92% to date, with graft survival 93%. The use of hearts from COVID-19 positive donors may be safe and effective. Transplantation of lungs is unresolved but may be cautiously pursued under the restricted circumstances.


Subject(s)
COVID-19 , Lung Transplantation , Tissue and Organ Procurement , Graft Survival , Humans , Lung Transplantation/methods , Tissue Donors
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