Utilization of deceased donors during a pandemic: argument against using SARS-CoV-2–positive donors

Shah, Malay B.; Lynch, Raymond; El‐Haddad, Hanine; Doby, Brianna; Brockmeier, Diane; Goldberg, David S.

doi:10.1111/ajt.15969

Cited by 55 publications

(71 citation statements)

References 22 publications

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“…64 However, the risk of disease transmission to the transplant team remains a major concern. 65 This may be an interesting option in the future, when effective vaccination comes available.…”

Section: Covid-19 and Deceased Donor Transplantationmentioning

confidence: 99%

COVID-19 and the liver

Jothimani

Venugopal

Abedin

et al. 2020

Journal of Hepatology

446

469

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The current coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has become a major public health crisis over the past few months. Overall case fatality rates range between 2-6%; however, the rates are higher in the elderly and those with underlying comorbidities like diabetes, hypertension and heart disease. Recent reports showed that about 2-11% of patients with COVID-19 had underlying chronic liver disease. During the previous SARS epidemic, around 60% of patients were reported to develop various degrees of liver damage. In the current pandemic, hepatic dysfunction has been seen in 14-53% of patients with COVID-19, particularly in those with severe disease. Cases of acute liver injury have been reported and are associated with higher mortality. Hepatic involvement in COVID-19 could be related to the direct cytopathic effect of the virus, an uncontrolled immune reaction, sepsis or drug-induced liver injury. The postulated mechanism of viral entry is through the host angiotensin-converting enzyme 2 (ACE2) receptors that are abundantly present in type 2 alveolar cells. Interestingly, ACE2 receptors are expressed in the gastrointestinal tract, vascular endothelium and cholangiocytes of the liver. The effects of COVID-19 on underlying chronic liver disease require detailed evaluation and, with data currently lacking, further research is warranted in this area.

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Section: Covid-19 and Deceased Donor Transplantationmentioning

confidence: 99%

COVID-19 and the liver

Jothimani

Venugopal

Abedin

et al. 2020

Journal of Hepatology

446

469

View full text Add to dashboard Cite

show abstract

“…The consensus is that kidneys from deceased or living donors with a confirmed infection or high exposure risk to COVID-19 should not be used. 30 To date, donor to recipient viral transmission lacks conclusive confirming data; however, it is certainly plausible. This is supported by the following: (1) Angiotensin-converting enzyme 2 is the receptor that binds the spike protein of SARS-CoV-2 and facilitates its entry into target cells.…”

Section: Donor To Recipient Viral Transmissionmentioning

confidence: 99%

COVID-19 in Kidney Transplantation: Outcomes, Immunosuppression Management, and Operational Challenges

Jawdeh

2020

Advances in Chronic Kidney Disease

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The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2, has led to the death of hundreds of thousands of people worldwide. If infected, older individuals and those with diabetes, hypertension, cardiovascular disease, and compromised immune systems are at higher risk for unfavorable outcomes. These comorbidities are prevalent in patients with kidney disease, hence the significant burden of COVID-19 on kidney transplant programs. Multiple case series of kidney transplant recipients with COVID-19 have shown increased mortality compared to nontransplant patients. To date, we do not have high-level evidence to inform immunosuppression minimization strategies in infected transplant recipients. Most centers however have adopted early antimetabolite withdrawal in addition to other interventions. This review summarizes the published COVID-19 literature as it relates to outcomes and immunosuppression management in kidney transplant recipients. It also discusses challenges pertaining to pretransplant evaluation and wait-listed patients.

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“…3 All potential donors are required to have a negative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid test nose and throat swab and endotracheal aspirate. 4 Many specialist nurses in organ donation were redeployed to various roles in ICUs and other COVID-19 related projects. Transplant priority was given for patients on the super urgent liver and heart transplantations lists.…”

mentioning

confidence: 99%