Health
A woman who died after a transplant was infected with COVID-19 from a donated lung
A woman who died after undergoing a double lung transplant at the University of Michigan Hospital in Ann Arbor was the first known person to be infected with COVID-19 from a donor’s lungs, according to a new case report announced. American Journal of Transplantation..
“As far as I know, this is the first and really only documented infection of COVID-19 recipients from donated organs,” he said. Life Gift Michigan, State federal designated organ and tissue recovery program.
The incident represents the “worst scenario” of a pandemic that killed nearly 500,000 Americans, but the Gift of Life Michigan wasn’t involved in the donation, Nice said. The transplant took place in late October and the donors came from outside the state.
A woman who had a double lung transplant suffered from chronic obstructive pulmonary disease and had a negative coronavirus test due to rapid use. Polymerase Chain Reaction (PCR) Test Details of the case report 12 hours before surgery.
An organ donor, a woman in the northern Midwest who suffered brain death in a car accident, also tested negative with a nasopharyngeal swab within 48 hours of procuring the organ.
The donor’s family reported that she had no travel history and had no recent COVID-19 symptoms. It was unknown whether the organ donor was exposed to a person infected with the virus.
The day after the transplant, the recipient’s heart was not pumped as efficiently as expected, and two days after the transplant she developed fever, hypotension, and dyspnea.
The doctor collected a sample of fluid from her lungs. Bronchoalveolar lavage, And SARS-CoV-2 tested its liquid. The result was positive.
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The same type of liquid from the organ donor was then tested for coronavirus with a positive result.
Shortly thereafter, the thoracic surgeon who underwent transplant surgery was also virus-positive. Whole-genome sequencing of all three showed that the disease was due to an organ donor and was likely to spread to recipients and surgeons during transplantation.
A woman who underwent a double lung transplant was treated with COVID-19 at the hospital and was given the antiviral drug Remdeciva, convalescent plasma, and steroids, but her symptoms worsened. She died about two months after the transplant surgery.
Studies suggest that transplant centers and organ procurement agencies should consider testing lower respiratory tract samples of potential lung donors to ensure that the virus is not passed to transplant recipients. I will. It also suggests that healthcare professionals need to wear complete personal protective equipment such as eyeglasses and N95 masks when performing lung transplant surgery or organ removal.
“Our heart is directed not only to the donor’s family, but also to the recipient’s family,” Nice said. “If the recipient of the donated organ dies, it can be a kind of double tragedy for the donor’s family as well.
“This case was one of the major challenges of donations and transplants in the pandemic era. The fact that some 110,000 people on the waiting list have been tested and do not rest in their terminal organs. There is an illness. A pandemic does not pause. Their illness continues to be sacrificed. They remain on the waiting list. “
In this case, no other organ from the donor was used for the transplant. The authors of the study warn that if other organs such as the kidney, liver, heart, and pancreas may pose for transplantation, they cannot be used to suggest a risk of coronavirus infection. did.
“I don’t think the risk of transplantation is completely eliminated in our field,” Nice said. “It’s usually a matter of life and death for the recipient, so everything is relative. Therefore, risk factors tend to be weighed against the patient’s health, the progression of the disease that hit him. Waiting for transplantation. Consideration and approval that there are probably some unknowns, as the list, and all known factors about the donor, and the tests remain incomplete for all.
“We have great technology for testing infectious diseases, but no one can absolutely guarantee that the pathogen is absent, so what we do is test all donors.
“Donations save lives,” he said. “That’s really important. So despite the pandemic, the need and potential to do good remains.”
Contact Kristen Shamus: [email protected]. Follow her on Twitter @ kristenshamus.
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