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Utilization and Discard of Organs from Covid -19 Infected Donors: A Us National Registry Analysis
American Journal of Transplantation ; 22(Supplement 3):403-404, 2022.
Article in English | EMBASE | ID: covidwho-2063346
ABSTRACT

Purpose:

Expansion of the donor pool remains a major unmet need for solid organ transplants (SOT). Early data suggests that at least some severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID) nucleic acid test positive (NAT+) organs could be transplanted safely although there is substantial controversy about this topic. Method(s) A retrospective analysis of the national United States Organ Procurement and Transplantation Network database was performed, demonstrating initial experience with COVID NAT+ deceased donor organs with a focus on kidney transplants, from August 8, 2020, to Sep 29, 2021. Result(s) During this time period, 17,143 COVID NAT negative (NAT-) deceased donors and 150 COVID NAT+ deceased donors were assessed for organ donation (Figure 1) (Table 1). When compared to COVID NAT- donors, there was a higher (p<0.001 for all) non-recovery rate for COVID NAT+ hearts (35% vs 87%), lungs (71% vs 99%), livers (24% vs 53%), and pancreas (89% vs 98 %). Of a total of 385 recovered organs from 150 COVID NAT+ donors, 276 (72%) organs were transplanted into 262 recipients. Majority of donors had a COVID NAT+ <=7 days prior to procurement (94;62.7%). While only a minority of pancreases, hearts, lungs, and livers were procured, almost all were transplanted post-procurement. In contrast, there was a high discard rate for kidneys post-procurement (102/295;34.6%) with the most common reason (~70%) for discards being 'exhaustion of the wait list'. Presumably superior quality COVID NAT+ kidneys were discarded compared with COVID NAT- kidneys (mean KDPI 67% vs 76%;p=0.04). Limited outcome data was available with a median post-transplant follow-up of 75 days (range 23-243 days). Three kidney allograft losses (2 due to allograft thrombosis) and five deaths (2 kidneys, 3 livers) were reported, of which, one was due to respiratory failure and one due to sepsis. Conclusion(s) These data provide early reassuring evidence on the utilization of non-lung COVID NAT+ organs. However, a substantially lower procurement rate for non-kidney transplantable organs and a high discard rate for kidneys were noted. (Table Presented).
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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: American Journal of Transplantation Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: American Journal of Transplantation Year: 2022 Document Type: Article