Study evaluates safety of transplants from SARS-CoV-2-positive donors

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Research published on Tuesday in Transplant Infectious Diseases evaluated the safety of transplants from organ donors who recently tested positive for SARS-CoV-2.

According to the investigative team, by providing evidence of the safety of organs from a SARS-CoV-2-positive donor, the study could help mitigate donated organ shortages. The demand for donated organs exceeds supply, with patients waiting months and sometimes years for a donor.

To evaluate the safety of transplants from SARS-CoV-2-positive organ donors, Dr. Jason Goldman, an infectious disease physician at the Organ Transplant and Liver Disease Center at Providence Swedish Hospital in Seattle, led a group of more than two dozen experts from the Organ Procurement and Transplantation Network ad hoc Disease Transmission Advisory Committee. 

The study investigated data from all U.S. donors and transplant recipients in the national database, as well as cases referred to the committee for review of possible transmission from donor to recipient. The review assessed 30-day outcomes for 1,241 transplant recipients from a donor testing positive for SARS-CoV-2 and 21,948 organ donors without a positive virus test.

The researchers found that non-lung transplant recipients from SARS-CoV-2-positive donors had 30-day graft and patient survival rates similar to non-lung transplant recipients from donors negative for SARS-CoV-2.

The researchers also evaluated the impacts of a 2021 emergency policy requiring organ procurement organizations to conduct lower respiratory track testing for SARS-CoV-2. The policy was launched in late May 2021 after the Centers for Disease Control and Prevention and the Disease Transmission Advisory Committee identified three cases in which SARS-CoV-2 was passed to lung transplant recipients from the donor after upper respiratory tract testing failed to identify the donors’ COVID-19 infections.

The researchers found that no probable or proven cases of COVID-19 transmission had occurred in recipients of non-lung organs (such as kidneys, livers, and hearts). Further, they found zero transmissions of COVID-19 to lung transplant recipients after the new policy requiring lower respiratory track testing in lung donors took effect.

“Our findings are particularly heartening for patients and providers grappling with the dual challenges of an organ shortage and uncertainty about the safety of organ transplants during the COVID-19 pandemic,” Goldman said in a statement. “Early guidance for transplant programs recommended avoiding donors who recently tested positive for SARS-CoV-2. However, this study provides key evidence that in most cases, transplants from SARS-CoV-2-positive donors can be used with excellent short-term outcomes.”

The researchers point to the need for additional studies regarding long-term outcomes, but they said their study provides evidence and reassurance for transplant recipients, donors, their loved ones, and providers regarding transplants during the COVID-19 pandemic.

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