COVID-19 positive donor for solid organ transplantation

Peghin, Maddalena; Grossi, Paolo

doi:10.1016/j.jhep.2022.06.021

Cited by 12 publications

(20 citation statements)

References 22 publications

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“…The present experience intends to contribute to better define the safety of the utilization of organs from donors who test positive for SARS‐CoV‐2 at the time of donation. Our results are aligned with other published experiences and support the apparent feasibility of this approach 3,27 . However, some specific aspects must be highlighted.…”

Section: Discussionsupporting

confidence: 91%

“…The routine screening of potential donors for SARS-CoV-2 by PCR has been established in all transplant guidelines released during the pandemic. 26,27 Initial guidelines also required negative results for SOT to proceed as the occurrence of donor-derived COVID-19 was deemed theoretically possible. However, this risk mainly lies in the presence of viable, transmissible virus in the transplanted organ.…”

Section: Discussionmentioning

confidence: 99%

“…Our results are aligned with other published experiences and support the apparent feasibility of this approach. 3,27 However, some specific aspects must be highlighted.…”

Section: Discussionmentioning

confidence: 99%

“…Relevant to the case of posttransplant COVID-19 related above is whether active search for SARS-CoV-2 RNA in transplanted organs should be recommended, as stated in the Italian guidelines. 27 This document recommends that, where possible, donor liver and kidney biopsies should be screened for SARS-CoV-2 RNA and histopathological changes, and that SARS-CoV-2 PCR should be performed in the preservation fluid. Biopsy of the heart graft is left at the discretion of the transplant center.…”

Section: Discussionmentioning

confidence: 99%

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Transplantation of organs from SARS‐CoV‐2‐positive donors: Preliminary experience from Spain

Villalonga

Martínez-Alpuente

Fernández‐Ruiz

et al. 2023

Transplant Infectious Dis

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Background The utilization of non‐lung organs from deceased donors with a positive polymerase chain reaction (PCR) for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) at the time of donation can be lifesaving, although the safety of this policy must be assessed. Methods This is a nationwide, prospective study, reporting the experience on the utilization of non‐lung organs from SARS‐CoV‐2‐positive donors between December 15, 2020 and May 31, 2022 in Spain. Results A total of 69 patients received a solid organ transplant (41 kidney, 18 liver, 8 heart, and 2 combined liver–kidney) obtained from 32 donors with a positive SARS‐CoV‐2 PCR at the time of donation (four of them with a cycle threshold value <30). All recipients tested negative for SARS‐CoV‐2 and were free of coronavirus disease 2019 (COVID‐19) symptoms prior to transplantation. Nasopharyngeal swab turned positive for SARS‐CoV‐2 PCR in 4 (5.8%) recipients at 3, 8, 11, and 20 days after transplantation, though evidence did not support a donor‐derived COVID‐19. Four kidney recipients lost their grafts and two patients died: one heart recipient due to cardiogenic shock and one combined liver–kidney recipient due to lung hypertension and right heart failure. Graft losses and patient deaths were deemed unrelated to the donor SARS‐CoV‐2 status by the treating teams. No other adverse reactions were reported. Conclusions This preliminary experience supports the safety of the use of organs other than lungs from SARS‐CoV‐2 PCR‐positive donors, in alignment with previous series. However, the impact of SARS‐CoV‐2 infection upon organ quality should be established in future research.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

“…Our results are aligned with other published experiences and support the apparent feasibility of this approach. 3,27 However, some specific aspects must be highlighted.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Transplantation of organs from SARS‐CoV‐2‐positive donors: Preliminary experience from Spain

Villalonga

Martínez-Alpuente

Fernández‐Ruiz

et al. 2023

Transplant Infectious Dis

View full text Add to dashboard Cite

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“…The decrease in elective surgeries and the lack of knowledge about the risks and mechanisms of virus transmission are two of the main causes. Therefore, potential donors who contract COVID-19 are not considered eligible to donate organs, further reducing the pool of available donors (Peghin & Grossi, 2022).…”

Section: Discussionmentioning

confidence: 99%

Quantification and persistence of COVID‐19 virus in recently deceased individuals before and after embalming

Gitto

Middleton

Reynolds

et al. 2023

Anatomical Sciences Ed

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The COVID‐19 pandemic severely affected the medical education worldwide. The infection risk for medical students and healthcare personnel who work with COVID‐19 positive cadavers or tissues remains unclear. Moreover, COVID‐19 positive cadavers have been rejected by medical schools, adversely impacting the continuum of medical education. Herein, the viral genome abundance in tissues from four COVID‐19 positive donors before and after embalming were compared. Tissue samples were collected from the lungs, liver, spleen, and brain both pre‐ and postembalming. The possible presence of infectious COVID‐19 was determined by inoculating human tissue homogenates onto a monolayer of human A549‐hACE2 cells and observing for cytopathic effects up to 72 h postinoculation. A real‐ time quantitative reverse transcription polymerase chain reaction was performed to quantify COVID‐19 present in culture supernatants. Fully intact viral genome sequence was possible to obtain in samples with higher levels of virus, even several days postmortem. The embalming procedure described above substantially reduces the abundance of viable COVID‐19 genomes in all tissues, sometimes even to undetectable levels. However, in some cases, COVID‐19 RNA can still be detected, and a cytopathic effect can be seen both pre‐ and postembalmed tissues. This study suggests that embalmed COVID‐19 positive cadavers might be used safely with appropriate precautions followed in gross anatomy laboratories and in clinical and scientific research. Deep lung tissue is the best specimen to test for the virus. If the tests on the lung tissues are negative, there is a very low likelihood that other tissues will show positive results.

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