Organ donation from dying patients diagnosed with coronavirus is generally safe and does not infect organ recipients with Covid-19, according to two new studies, one American and one Italian, which will be presented at the conference of the European Society of Clinical Microbiology Diseases in Lisbon (ECCMID 2022).
The first study, led by Dr. Cameron Wolf and Dr. Emily Eisenberger of Duke University School of Medicine in North Carolina, looked at liver, pancreas and kidney transplants (a total of six organs) in four patients diagnosed with 19 C-diagnosed donors. . A biopsy was performed to confirm the suitability of the organs for transplantation. Of the donors, one died due to severe complications of Covid-19, the other died from another microbial infection in the brain that may have been triggered by the coronavirus, while the other two had mild to moderate Covid-19 and eventually died from other causes.
No organs were rejected by the recipient’s body and no organ recipients became infected with Covid-19 through the graft. Dr Eisenberger said: “Although limited, our experience to date supports the use of abdominal organs by Covid-19-positive donors as safe and effective, even for those with active Covid-19 infection or pneumonia due to Covid-19.”
The pandemic had exacerbated the shortage of organs for transplantation, including concerns about the unknown risks of using organs from donors with Covid-19. The greatest deficiency was observed in the kidneys and then in the lungs, liver and hearts.
According to experts, not all organs are suitable for transplantation from coronavirus donors. For example, if the organ to be donated is a lung or intestine, it is only accepted if more than 20 days have passed since the donor was diagnosed as positive for the virus. If coronavirus is detected at the base of the lungs, then the organ is discarded. On the other hand, to reduce the risk further, all organ recipients must be fully vaccinated against coronavirus with Pfizer / BioNTech or Moderna before transplantation.
According to Eisenberger, “being unvaccinated can increase the risk of serious Covid-19 in transplant patients due to the immunosuppressive drugs they take after the transplant. “For this reason, we strongly encourage patients on the waiting list to be vaccinated, although just because someone is not vaccinated does not mean that they are excluded from the transplant waiting list.” It should be noted, however, that unlike the US, where protocols are more relaxed depending on the state, many countries insist that all donors must be triple-vaccinated before transplantation, while unvaccinated recipients are not accepted.
The second study, led by Professor Paolo Grossi of the University of Insubria in Varese, looked at 30 transplants from donors with a past Covid-19 infection and another 38 from donors with an active Covid-19 infection at the time of death. The conclusion was that organ recipients from patients with either previous or even active Covid-19 could have a transplant if the donor was asymptomatic or died of a cause other than coronavirus.
Grossi said: “Based on the growing global experience, we believe that donor organs with a history of SARS-CoV-2 infection or active their vaccination. “This can increase the availability of organs for transplantation.” He also noted that in both Italy and other countries, transplant activity has almost returned to pre-pandemic levels.
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