Successful kidney transplantation from a deceased donor with severe COVID-19 respiratory illness with undetectable SARS-CoV-2 in donor kidney and aorta

Abstract

Kidney transplantation (KT) from coronavirus disease 2019 (COVID-19) donors were avoided due to concerns for donor-derived transmission. 1,2 There have been no data on the long-term safety,

Utilization and outcomes of deceased donor SARS-CoV-2–positive organs for solid organ transplantation in the United States

“…One of the primary findings from the study was that recipient outcomes with use of SARS‐CoV‐2–positive donor organs are similar to outcomes with negative testing. These data complement prior smaller single‐center reports and case series and may provide assurance that, at least short‐term outcomes are not compromised by use of these organs 7–11,13,20,21 . In the context of kidney transplantation, the current study indicated no difference in rates of delayed graft function or 6‐month graft survival and the characteristics of recipients was similar between negative and positive SARS‐CoV‐2 status donors.…”

“…These data complement prior smaller single‐center reports and case series and may provide assurance that, at least short‐term outcomes are not compromised by use of these organs. 7 , 8 , 9 , 10 , 11 , 13 , 20 , 21 In the context of kidney transplantation, the current study indicated no difference in rates of delayed graft function or 6‐month graft survival and the characteristics of recipients was similar between negative and positive SARS‐CoV‐2 status donors. Similarly for liver and transplant recipients, both general characteristics of recipients and 6‐month graft survival were similar by SARS‐CoV‐2 status donors.…”

“… 7 , 8 , 9 Due to ongoing uncertainties regarding the relative risks of transplantation with donors with prior or active infections, evidence for the safe use of organs from SARS‐CoV‐2–positive donors has emerged slowly with small case series from individual centers. 8 , 10 , 11 , 12 , 13 , 14 , 15 , 16 Although early results appear promising, best practices for utilization of positive SARS‐CoV‐2 donors remain unclear. 7 , 8 , 9 , 11 , 17 , 18 , 19 …”

“…With the exception of lung transplantation, the mechanisms of potential transmission of infection by organ donation have remained theoretical 7–9 . Due to ongoing uncertainties regarding the relative risks of transplantation with donors with prior or active infections, evidence for the safe use of organs from SARS‐CoV‐2–positive donors has emerged slowly with small case series from individual centers 8,10–16 . Although early results appear promising, best practices for utilization of positive SARS‐CoV‐2 donors remain unclear 7–9,11,17–19 …”

SARS-CoV-2 pirates the kidneys: A scar(y) story

“…provided the first hints that SARS-CoV-2 infection in kidney organoids is amenable to a treatment with a protease inhibitor, providing a glimpse into potential future treatments for COVID-19-related kidney injury. The findings also stimulate further clinical and translational investigations for testing SARS-CoV-2 tropism in the kidneys of infected individuals to identify potential virus-free kidneys for transplantation procured from individuals who died of fulminant COVID-19 ( Lee et al., 2022 ).…”