Donor and Transplant Candidate Selection for Solid Organ Transplantation During the COVID-19 Pandemic

Authors

N Thao N Galvan
Nicolas F Moreno
Jay E Garza
Susan Bourgeois
Marion Hemmersbach-Miller
Bhamidipati Murthy
Katherine Timmins
Christine A O'Mahony
James Anton
Andrew Civitello
Puneet Garcha
Gabe Loor
Kenneth Liao
Alexis Shaffi
John Vierling
Rise Stribling
Abbas Rana
John A Goss

Publication Date

11-1-2020

Journal

American Journal of Transplantation

DOI

10.1111/ajt.16138

PMID

32524743

PMCID

PMC9800695

Published Open-Access

no

Keywords

COVID-19, Humans, Organ Transplantation, Pandemics, Patient Selection, SARS-CoV-2, Tissue Donors, Tissue and Organ Procurement, Transplant Recipients, Waiting Lists, clinical decision-making, clinical research/practice, donors and donation: donor evaluation, health services and outcomes research, infection and infectious agents – viral, infectious disease, organ allocation, organ procurement and allocation, organ transplantation in general, waitlist management

Abstract

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a novel coronavirus responsible for a worldwide pandemic has forced drastic changes in medical practice in an alarmingly short period of time. Caregivers must modify their strategies as well as optimize the utilization of resources to ensure public and patient safety. For organ transplantation, in particular, the loss of lifesaving organs for transplantation could lead to increased waitlist mortality. The priority is to select uninfected donors to transplant uninfected recipients while maintaining safety for health care systems in the backdrop of a virulent pandemic. We do not yet have a standard approach to evaluating donors and recipients with possible SARS-CoV-2 infection. Our current communication shares a protocol for donor and transplant recipient selection during the coronavirus disease 2019 (COVID-19) pandemic to continue lifesaving solid organ transplantation for heart, lung, liver, and kidney recipients. The initial results using this protocol are presented here and meant to encourage dialogue between providers, offering ideas to improve safety in solid organ transplantation with limited health care resources. This protocol was created utilizing the guidelines of various organizations and from the clinical experience of the authors and will continue to evolve as more is understood about SARS-CoV-2 and how it affects organ donors and transplant recipients.

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