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. 2022 Sep;22(9):2203-2216.
doi: 10.1111/ajt.17145. Epub 2022 Jul 25.

Organ transplantation using COVID-19-positive deceased donors

Matthew J Bock  1 , Gabrielle R Vaughn  1 , Peter Chau  1 , Jennifer A Berumen  2 , John J Nigro  3 , Elizabeth G Ingulli  4
Affiliations

Organ transplantation using COVID-19-positive deceased donors

Matthew J Bock et al. Am J Transplant. 2022 Sep.

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.

Keywords: United Network for Organ Sharing (UNOS); clinical research/practice; donors and donation: deceased; infection and infectious agents-viral: SARS-CoV-2/COVID-19; infectious disease; patient survival; solid organ transplantation.

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Figures

FIGURE 1
FIGURE 1
Coronavirus disease‐2019 (COVID‐19) pandemic timeline of events. Rec'd,  Recommended
FIGURE 2
FIGURE 2
Cumulative COVID‐19 NAT testing of potential transplant donors in the U.S. between March 15, 2020 and September 30, 2021. NAT, nucleic acid test
FIGURE 3
FIGURE 3
Stratification of all transplant recipients in the U.S. between March 15, 2020 and September 30, 2021. NAT, nucleic acid test
FIGURE 4
FIGURE 4
Stratification of all potential transplant donors and organs transplanted from COVID‐19 NAT‐positive donors in the U.S. between March 15, 2020 and September 30, 2021. NAT, nucleic acid test
FIGURE 5
FIGURE 5
Cumulative number of donors with positive COVID‐19 NAT testing in the U.S. between March 15, 2020 and September 30, 2021. NAT, nucleic acid test
FIGURE 6
FIGURE 6
Actuarial post‐transplant patient survival stratified by donor COVID‐19 NAT result between March 15, 2020 and September 30, 2021 (all organs). NAT, nucleic acid test
FIGURE 7
FIGURE 7
Actuarial post‐transplant patient survival stratified by organ transplanted between March 15, 2020 and September 30, 2021 (COVID‐19 NAT‐positive donors only). NAT, nucleic acid test
FIGURE 8
FIGURE 8
Actuarial post‐transplant graft survival stratified by donor COVID‐19 NAT result between March 15, 2020 and September 30, 2021 (all organs). NAT, nucleic acid test
FIGURE 9
FIGURE 9
Actuarial post‐transplant graft survival stratified by organ transplanted between March 15, 2020 and September 30, 2021 (COVID‐19 NAT‐positive donors only). NAT, nucleic acid test
See this image and copyright information in PMC

References

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