Organ Transplantation from Donors with Active SARS-CoV-2 Infection: The Italian Experience

ABSTRACT

Purpose: In the present study we want to report safety and outcome of organ transplantation from donors with active SARS-CoV-2 infection in Italy. Method(s) In November 2020 the Italian CNT allowed the use of hearts and livers from asymptomatic donors with incidentally discovered active SARS-CoV-2 infection. Organ could be offered to candidates with asymptomatic or resolved COVID-19 or with a full COVID-19 vaccination (3 doses with documented seroconversion) and to Kidney transplant candidates with resolved COVID-19 or with a full course of anti-COVID-19 vaccination. After transplantation all recipients underwent SARS-CoV-2 RNA detection on respiratory secretions on a weekly basis for up to 4 weeks after transplantation. Result(s) From November 21, 2020 to January 23, 2022 we have performed 44 solid organ transplants (33 livers, including 3 split, 5 hearts and 6 kidneys), in 34 males, and 10 females, mean age 49.5 years, range 0-70), from 32 donors (18 males, mean age 47.9, range 14-82) with active SARS-CoV-2 infection and cause of death unrelated to COVID-19. None of the recipients developed a donor derived SARS-CoV-2 infection. Conclusion(s) We believe that the use of non-lung organs from donors with active SARS-CoV-2 infection in selected and consented recipients may contribute to safely increase the donors pool.