Transplanting thoracic COVID-19 positive donors: An institutional protocol and report of the first 14 cases

胸部 COVID-19 阳性供体的移植:机构方案和前 14 例病例报告

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作者:Emily M Eichenberger, Amanda C Coniglio, Carmelo Milano, Jacob Schroder, Benjamin S Bryner, Philip J Spencer, John C Haney, Jacob Klapper, Carolyn Glass, Elizabeth Pavlisko, Louis Dibernardo, Chetan B Patel, Adam D DeVore, John Reynolds, Cameron R Wolfe

Abstract

We present our institution's protocol for evaluating and transplanting thoracic organs from COVID-19 positive donors and report the outcomes to date. Hearts from donors testing positive for COVID-19 on any test were eligible for transplantation at our institution provided the donor exhibited no evidence of hypercoagulability or COVID-19 induced hyperinflammatory state during terminal hospitalization. Lungs were eligible if the donor first tested PCR positive on nasopharyngeal swab (NPS) for COVID-19 > 20 days prior to procurement and had a negative lower respiratory tract specimen. We performed 14 thoracic transplants in 13 recipients using organs from COVID-19 positive donors. None of the recipients or healthcare members acquired COVID-19. No recipients suffered unexpected acute rejection. Patient survival is 92% to date, with graft survival 93%. The use of hearts from COVID-19 positive donors may be safe and effective. Transplantation of lungs is unresolved but may be cautiously pursued under the restricted circumstances.

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