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Solid organ transplantation from donors with recent or current SARS-CoV-2 infection: A systematic review.
Martinez-Reviejo, Raquel; Tejada, Sofia; Cipriano, Ana; Karakoc, Hanife Nur; Manuel, Oriol; Rello, Jordi.
  • Martinez-Reviejo R; Clinical Research/Epidemiology in Pneumonia & Sepsis (CRIPS), Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain; Centro de Investigación Biomédica En Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
  • Tejada S; Clinical Research/Epidemiology in Pneumonia & Sepsis (CRIPS), Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain; Centro de Investigación Biomédica En Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. Electronic address: stmagraner@gmail.com.
  • Cipriano A; Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
  • Karakoc HN; Karadeniz Technical University School of Medicine, Trabzon, Turkey.
  • Manuel O; Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Transplantation Centre, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
  • Rello J; Clinical Research/Epidemiology in Pneumonia & Sepsis (CRIPS), Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain; Centro de Investigación Biomédica En Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Department of Medicine, Universitat Internac
Anaesth Crit Care Pain Med ; 41(4): 101098, 2022 08.
Article in English | MEDLINE | ID: covidwho-1821095
ABSTRACT

BACKGROUND:

Solid-organ transplantation (SOT) from SARS-CoV-2 positive donors could be a life-saving opportunity worth grasping. We perform a systematic review to evaluate the recipient outcomes of SOT from donors with recent or current SARS-CoV-2 infection.

METHODS:

Search strategy was performed in PubMed, Cochrane COVID-19 Study Register, and Web of Science databases from the 1st of January 2019 to the 31st of December 2021. SOT adult recipients from a donor with past or current SARS-CoV-2 infection were elegible for inclusion. Outcomes were viral transmission, COVID-19 symptoms, mortality, hospital stay, and complications. PROSPERO Register Number CRD42022303242

FINDINGS:

Sixty-nine recipients received 48 kidneys, 18 livers and 3 hearts from 57 donors. Six additional transplants from positive lungs were identified. IgG+ anti-SARS-CoV-2 titers were detected among 10/16 recipients; only 4% (3/69) recipients were vaccinated. Non-lung transplant recipients received organs from 10/57 (17.5%) donors with persistent COVID-19. In 18/57 donors, SARS-CoV-2 RNA was detected (median 32 Cycle threshold [Ct]) at procurement. Among non-lung transplant recipients, SARS-CoV-2 viral transmission was not documented. Four patients presented delayed graft dysfunction, two patients acute rejection, and two patients died of septic shock. The median (IQR) hospital stay was 18 (11-28) days in recipients from symptomatic donors. Viral transmission occurred from three lung donors to their recipients, who developed COVID-19 symptoms. One of the recipients subsequently died.

CONCLUSION:

Use of non-lung (kidney, liver and heart) organs from SARS-CoV-2 positive donors seem to be a safe practice, with a low risk of transmission irrespective of the presence of symptoms at the time of procurement. Low viral replication (Ct > 30) was safe among non-lung donors, even if persistently symptomatic at procurement.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Organ Transplantation / COVID-19 Type of study: Experimental Studies / Prognostic study / Reviews / Systematic review/Meta Analysis Topics: Long Covid / Vaccines Limits: Adult / Humans Language: English Journal: Anaesth Crit Care Pain Med Year: 2022 Document Type: Article Affiliation country: J.accpm.2022.101098

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Organ Transplantation / COVID-19 Type of study: Experimental Studies / Prognostic study / Reviews / Systematic review/Meta Analysis Topics: Long Covid / Vaccines Limits: Adult / Humans Language: English Journal: Anaesth Crit Care Pain Med Year: 2022 Document Type: Article Affiliation country: J.accpm.2022.101098