Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug;41(4):101098.
doi: 10.1016/j.accpm.2022.101098. Epub 2022 May 6.

Solid organ transplantation from donors with recent or current SARS-CoV-2 infection: A systematic review

Raquel Martinez-Reviejo  1 , Sofia Tejada  2 , Ana Cipriano  3 , Hanife Nur Karakoc  4 , Oriol Manuel  5 , Jordi Rello  6
Affiliations

Solid organ transplantation from donors with recent or current SARS-CoV-2 infection: A systematic review

Raquel Martinez-Reviejo et al. Anaesth Crit Care Pain Med. 2022 Aug.

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.

Keywords: COVID-19; Organ donation; Solid organ transplantation; Viral transmission.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram of the study selection.
Fig. 2
Fig. 2
Summary of non-lung transplantation from 57 donors with SARS-CoV-2 infection.
Fig. 3
Fig. 3
Summary of lung transplantation from six donors with SARS-CoV-2 infection.
See this image and copyright information in PMC

Comment in

References

    1. Akalin E., Azzi Y., Bartash R., Seethamraju H., Parides M., Hemmige V., et al. Covid-19 and kidney transplantation. N Engl J Med. 2020;382:2475–2477. doi: 10.1056/NEJMc2011117. - DOI - PMC - PubMed
    1. Chandorkar A., Coro A., Natori Y., Anjan S., Abbo L.M., Guerra G., et al. Kidney transplantation during coronavirus 2019 pandemic at a large hospital in Miami. Transpl Infect Dis. 2020;22 doi: 10.1111/tid.13416. - DOI - PMC - PubMed
    1. Bordes S.J., Montorfano L., West-Ortiz W., Valera R., Cracco A., Alonso M., et al. Trends in US kidney transplantation during the COVID-19 pandemic. Cureus. 2020;12 doi: 10.7759/cureus.12075. - DOI - PMC - PubMed
    1. Di Maira T., Berenguer M. COVID-19 and liver transplantation. Nat Rev Gastroenterol Hepatol. 2020;17:1–3. doi: 10.1038/s41575-020-0347-z. - DOI - PMC - PubMed
    1. Organ Procurement and Transplantation Network (OPTN) COVID-19. Organ procurement and transplantation network. 2022. https://optn.transplant.hrsa.gov/covid-19 (Accessed 21 March 2022)

Publication types