Successful transplantation of organs from a deceased donor with early SARS-CoV-2 infection

Dhand, Abhay; Gass, Alan; Nishida, Seigo; Kai, Masashi; Berger, Karen; Wolf, David C.; Ohira, Suguru; Sogawa, Hiroshi; Lee, Leslie; Lebovics, Edward; Ezzell, Chad; Diflo, Thomas; Spielvogel, David; Latifi, Rifat; Friedman, Amy L.

doi:10.1111/ajt.16706

Cited by 20 publications

(31 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To date, there are only 13 single case reports and 1 multicenter case series (N = 10) cumulatively of 24 nonlung organ transplants (16 kidneys, 15 livers, and 3 hearts) from SARS-CoV-2-infected donors. [8][9][10][11][12][13][14][15][16][17][18] Fifteen of those 24 recipients had no previous SARS-CoV-2 infection or vaccination (8/16 kidney recipients, 5/15 liver recipients, 2/3 heart recipients), and there was no virus transmission. There are also reports of at least 45 kidneys, 14 livers, and 6 hearts transplanted from 55 donors with fully resolved SARS-CoV-2 infection with no evidence of virus transmission.…”

Section: Discussionmentioning

confidence: 99%

Solid Organ Transplantation From SARS-CoV-2–infected Donors to Uninfected Recipients: A Single-center Experience

Jayasekera

Vikram

Rifat

et al. 2022

Transplantation Direct

View full text Add to dashboard Cite

Background. The risk of donor-derived severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in solid organ (heart, lung, liver, kidney, pancreas, and intestine) transplant recipients is poorly understood. Since hematogenous transmission of SARS-CoV-2 has not been documented to date, nonlung solid organs might be suitable for transplantation since they likely portend a low risk of viral transmission. Methods. Abdominal solid organs from SARS-CoV-2–infected donors were transplanted into uninfected recipients. Results. Between April 18, 2021, and October 30, 2021, we performed transplants of 2 livers, 1 simultaneous liver and kidney, 1 kidney, and 1 simultaneous kidney and pancreas from SARS-CoV-2–infected donors into 5 uninfected recipients. None of the recipients developed SARS-CoV-2 infection or coronavirus disease 2019, and when tested, allograft biopsies showed no evidence of SARS-CoV-2 RNA. Conclusions. Transplanting nonlung organs from SARS-CoV-2–infected donors into uninfected recipients demonstrated no evidence of virus transmission.

show abstract

Section: Discussionmentioning

confidence: 99%

Solid Organ Transplantation From SARS-CoV-2–infected Donors to Uninfected Recipients: A Single-center Experience

Jayasekera

Vikram

Rifat

et al. 2022

Transplantation Direct

View full text Add to dashboard Cite

show abstract

“…The use of casirivimab-imdevimab increased after their initial approval and in the setting of the emergence of SARS-CoV-2 variants [30,32]. This clinical data, along with the knowledge of the preserved in vitro activity of C-I, B-E, and sotrovimab against circulating predominant variants, can help identify the potential strengths and weaknesses of various available monoclonal antibody options and their future use [38]. These studies also address specific issues pertinent to SOTRs regarding the safety of infusion, risk of acute allograft rejection, and possible immune activation.…”

Section: Anti-sars-cov-2 Monoclonal Antibody In Solid Organ Transplan...mentioning

confidence: 99%

COVID-19 and Solid Organ Transplantation: Role of Anti-SARS-CoV-2 Monoclonal Antibodies

Dhand

Razonable

2022

Curr Transpl Rep

Self Cite

View full text Add to dashboard Cite

Purpose of Review Solid organ transplant recipients (SOTRs) are ideal candidates for early treatment or prevention of coronavirus disease 2019 (COVID-19) using anti-SARS-CoV-2 monoclonal antibodies because of multiple underlying medical conditions, chronic immune-suppression, sub-optimal immunogenic response to vaccination, and evolving epidemiological risks. In this article, we review pertinent challenges regarding the management of COVID-19 in SOTRs, describe the role of active and passive immunity in the treatment and prevention of COVID-19, and review real-world data regarding the use of anti-SARS-CoV-2 monoclonal antibodies in SOTRs. Recent Findings The use of an anti-SARS-CoV-2 monoclonal antibody in high-risk solid organ transplant recipients is associated with a reduction in the risk of hospitalization, need for intensive care, and death related to COVID-19. Overall, the early experiences from a diverse population of solid organ transplant recipients who were treated with anti-spike monoclonal antibodies are encouraging with no reported acute graft injury, severe adverse events, or deaths related to COVID-19. Summary Anti-SARS-CoV-2 antibodies are currently authorized for treatment of mild-moderate COVID-19 and post-exposure prophylaxis, including in SOTRs. Potential future uses include pre-exposure prophylaxis in certain high-risk persons and synergistic use along with emerging oral treatment options. Successful timely administration of anti-SARS-CoV-2 monoclonal antibodies requires a multidisciplinary team approach, effective communication between patients and providers, awareness of circulating viral variants, acknowledgement of various biases affecting treatment, and close monitoring for efficacy and tolerability.

show abstract

“… 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 …”

Section: Introductionmentioning

confidence: 99%

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

Schold

Koval

Wee

et al. 2022

American Journal of Transplantation

View full text Add to dashboard Cite

Coronavirus disease‐19 has had a marked impact on the transplant population and processes of care for transplant centers and organ allocation. Several single‐center studies have reported successful utilization of deceased donors with positive severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) tests. Our aims were to characterize testing, organ utilization, and transplant outcomes with donor SARS‐CoV‐2 status in the United States. We used Scientific Registry of Transplant Recipients data from March 12, 2020 to August 31, 2021 including a custom file with SARS‐CoV‐2 testing data. There were 35 347 donor specimen SARS‐CoV‐2 tests, 77.5% upper respiratory samples, 94.6% polymerase chain reaction tests, and 1.2% SARS‐CoV‐2–positive tests. Donor age, gender, history of hypertension, and diabetes were similar by SARS‐CoV‐2 status, while positive SARS‐CoV‐2 donors were more likely African‐American, Hispanic, and donors after cardiac death ( p ‐values <.01). Recipient demographic characteristics were similar by donor SARS CoV‐2 status. Adjusted donor kidney discard (odds ratio = 2.08, 95% confidence interval [CI] 1.66–2.61) was higher for SARS‐CoV‐2–positive donors while donor liver (odds ratio = 0.44, 95% CI 0.33–0.60) and heart recovery (odds ratio = 0.44, 95% CI 0.31–0.63) were significantly reduced. Overall post‐transplant graft survival for kidney, liver, and heart recipients was comparable by donor SARS‐CoV‐2 status. Cumulatively, there has been significantly lower utilization of SARS‐CoV‐2 donors with no evidence of reduced recipient graft survival with variations in practice over time.

show abstract

Successful transplantation of organs from a deceased donor with early SARS-CoV-2 infection

Cited by 20 publications

References 4 publications

Solid Organ Transplantation From SARS-CoV-2–infected Donors to Uninfected Recipients: A Single-center Experience

Solid Organ Transplantation From SARS-CoV-2–infected Donors to Uninfected Recipients: A Single-center Experience

COVID-19 and Solid Organ Transplantation: Role of Anti-SARS-CoV-2 Monoclonal Antibodies

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

Contact Info

Product

Resources

About