Transplant of organs from donors with positive SARS-CoV-2 nucleic acid testing: A report from the organ procurement and transplantation network ad hoc disease transmission advisory committee.

Autor: Goldman JD; Organ Transplant and Liver Center, Swedish Medical Center, Seattle, Washington, USA.; Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA., Pouch SM; Emory University School of Medicine, Atlanta, Georgia, USA., Woolley AE; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA., Booker SE; United Network for Organ Sharing, Richmond, Virginia, USA., Jett CT; United Network for Organ Sharing, Richmond, Virginia, USA., Fox C; United Network for Organ Sharing, Richmond, Virginia, USA., Berry GJ; Department of Pathology, Stanford University School of Medicine, Stanford, California, USA., Dunn KE; Yale New Haven Hospital, New Haven, Connecticut, USA., Ho CS; Gift of Hope Organ and Tissue Donor Network, Itasca, Illinois, USA.; College of Human Medicine, Michigan State University, East Lansing, Michigan, USA., Kittleson M; Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA., Lee DH; Division of Infectious Diseases, University of California San Francisco, San Francisco, California, USA., Levine DJ; Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA., Marboe CC; Department of Pathology and Cell Biology, Columbia University New York, New York, New York, USA., Marklin G; Mid-America Transplant, St. Louis, Missouri, USA., Razonable RR; Division of Public Health, Infectious Diseases and Occupational Medicine and the William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota, USA., Taimur S; Icahn School of Medicine at Mount Sinai, New York, New York, USA., Te HS; Center for Liver Diseases, University of Chicago Medicine, Chicago, Illinois, USA., Anesi JA; Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Fisher CE; Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA., Sellers MT; DCI Donor Services, Inc., Nashville, Tennessee, USA., Trindade AJ; Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Wood RP; LifeGift Organ Donation Center, Houston, Texas, USA., Zaffiri L; Department of Medicine, Duke University, Durham, North Carolina, USA., Levi ME; Division of Transplantation, Health Systems Bureau, Health Resources and Services Administration, Rockville, Maryland, USA., Klassen D; Office of the Chief Medical Officer, United Network for Organ Sharing, Richmond, Virginia, USA., Michaels MG; Department of Pediatrics, School of Medicine, University of Pittsburg, Pittsburg, Pennsylvania, USA., La Hoz RM; Division of Infectious Disease and Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA., Danziger-Isakov L; Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.
Jazyk: angličtina
Zdroj: Transplant infectious disease : an official journal of the Transplantation Society [Transpl Infect Dis] 2023 Feb; Vol. 25 (1), pp. e14013. Date of Electronic Publication: 2023 Jan 24.
DOI: 10.1111/tid.14013
Abstrakt: Background: Decisions to transplant organs from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid test-positive (NAT+) donors must balance risk of donor-derived transmission events (DDTE) with the scarcity of available organs.
Methods: Organ Procurement and Transplantation Network (OPTN) data were used to compare organ utilization and recipient outcomes between SARS-CoV-2 NAT+ and NAT- donors. NAT+ was defined by either a positive upper or lower respiratory tract (LRT) sample within 21 days of procurement. Potential DDTE were adjudicated by OPTN Disease Transmission Advisory Committee.
Results: From May 27, 2021 (date of OTPN policy for required LRT testing of lung donors) to January 31, 2022, organs were recovered from 617 NAT+ donors from all OPTN regions and 53 of 57 (93%) organ procurement organizations. NAT+ donors were younger and had higher organ quality scores for kidney and liver. Organ utilization was lower for NAT+ donors compared to NAT- donors. A total of 1241 organs (776 kidneys, 316 livers, 106 hearts, 22 lungs, and 21 other) were transplanted from 514 NAT+ donors compared to 21 946 organs from 8853 NAT- donors. Medical urgency was lower for recipients of NAT+ liver and heart transplants. The median waitlist time was longer for liver recipients of NAT+ donors. The match run sequence number for final acceptor was higher for NAT+ donors for all organ types. Outcomes for hospital length of stay, 30-day mortality, and 30-day graft loss were similar for all organ types. No SARS-CoV-2 DDTE occurred in this interval.
Conclusions: Transplantation of SARS-CoV-2 NAT+ donor organs appears safe for short-term outcomes of death and graft loss and ameliorates the organ shortage. Further study is required to assure comparable longer term outcomes.
(© 2023 Wiley Periodicals LLC.)
Databáze: MEDLINE
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