Publication Date
12-1-2022
Journal
Pediatric Transplantation
DOI
10.1111/petr.14407
PMID
36195971
PMCID
PMC9874761
PubMedCentral® Posted Date
10-4-2022
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
Humans, Child, Adult, Male, Infant, Child, Preschool, SARS-CoV-2, Pandemics, Liver Transplantation, COVID-19, Tissue Donors, COVID‐19, donor pool expansion, pediatric liver transplantation, SARS‐CoV‐2, SARS‐CoV‐2+ organ donation, viral transmission
Abstract
BACKGROUND: Amid a viral pandemic with poorly understood transmissibility and pathogenicity in the pediatric patient, we report the first pediatric liver transplants utilizing allografts from SARS-CoV-2+ donors.
METHODS: We describe the outcomes of two pediatric liver transplant recipients who received organs from SARS-CoV-2 nucleic acid test-positive (NAT+) donors. Data were obtained through the respective electronic medical record system and UNet DonorNet platform.
RESULTS: The first donor was a 3-year-old boy succumbing to head trauma. One of four nasopharyngeal (NP) swabs and 1 of 3 bronchoalveolar lavage (BAL) NAT tests demonstrated SARS-CoV-2 infection before organ procurement. The second donor was a 16-month-old boy with cardiopulmonary arrest of unknown etiology. Three NAT tests (2 NP swab/1 BAL) prior to procurement failed to detect SARS-CoV-2. The diagnosis was made when the medical examiner repeated 2 NP swab NATs and an archive plasma NAT, all positive for SARS-CoV-2. Both 2-year-old recipients continue to do well 8 months post-transplant, with excellent graft function and no evidence of SARS-CoV-2 transmission.
CONCLUSIONS: This is the first report to describe successful pediatric liver transplantation from SARS-CoV-2+ donors. These data reinforce the adult transplant experience and support the judicious use of SARS-CoV-2+ donors for liver transplantation in children. With SARS-CoV-2 becoming endemic, the concern for donor-derived viral transmission must now be weighed against the realized benefit of life-saving transplantation in the pediatric population as we continue to work toward donor pool maximization.
Included in
Community Health and Preventive Medicine Commons, COVID-19 Commons, Digestive System Diseases Commons, Epidemiology Commons, Gastroenterology Commons, Hepatology Commons, Medical Sciences Commons, Pediatrics Commons, Respiratory Tract Diseases Commons