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Double lung transplant recipients obtained covid-19 from donor organs, report found




Cowl wondered when the results returned to positive. [have] Did you come from a donor? “

Additional tests immediately confirmed the suspicion of the cowl. An unnamed woman who died of covid-19 two months later was actually infected with the virus from the donor’s infected lungs.The discovery of the cowl Release In a peer-reviewed treatise By the American Journal of Transplantation earlier this month.

“This is the first proven case of covid-19 infection through organ transplantation, at least in the United States,” Cowl, director of transplant infection services in Michigan medicine, told the Washington Post on Monday night. It was.

This treatise identifies a new new path for viruses, Mr. Cowl said the risk of developing it from transplant surgery is very low and his report should not discourage anyone from considering a transplant. Instead, he said he pointed out the need for more testing to prevent similar cases in the future.

Last year, more than 39,000 transplants were made in the United States. Compiled data By United Network for Organ Sharing (UNOS) 2,500 lung surgeries. Some covid-19 patients are also beginning to receive a lung transplant.In June of last year, a woman in her twenties who had a lung puncture due to this disease The first known covid-19 patient to undergo a double lung transplant In the United States

Ajeet Vinayak of Georgetown University Hospital has analyzed how covid-19 attacks the patient’s lungs, leaving the possibility of long-term injury. (John Farrell / Washington Post)

Cowl refused to disclose specific details about donors and recipients, as well as additional details about the time frame of surgery, to protect their identities.

A donor, a woman from the Upper Midwest who died in a serious car accident, and a recipient, a woman with chronic obstructive pulmonary disease. Lung disease coincided last fall, according to Cowl’s report.

Both women underwent multiple tests and clinical evaluations before the surgery was approved. Donors who underwent a coronavirus nasal swab test within 48 hours of procurement were negative. Lung scans showed no signs of covid-19, Cowl said. The woman’s family told her doctor that she had “no travel history” or had no recent symptoms such as fever, cough, headache, or diarrhea.

Recipients also tested negative for the virus 12 hours before transplantation.

On the day of surgery at a university hospital in Ann Arbor, Michigan, the surgery was performed without complications, the report said. Later that day, the recipient was taken to the intensive care unit and began to recover. But three days later, the woman began to show severe covid-19 symptoms. After her negative nasal swab, the doctor also collected a liquid sample from the depths of her lungs, which returned positive.

“I was seeing a patient and was very worried that it might have come from a donor, because it is very rare that it is deep in the lungs rather than in the upper respiratory tract. [nose and throat,]Cowl told the post.

“Then the question was how to prove it. How do you know where it came from?”

To answer that question, Cowl tested the fluid collected from the donor’s lungs during procurement. Returned to positive.

“That said: these lungs were infected,” Cowl told Post. “These lungs co-existed in them before entering the recipient.”

Around the same time, about three days after surgery, one of the surgeons who had direct contact with the lungs also began to show symptoms. He later tested positive for the virus, but did not require hospitalization, Cowl said.

Cowl ran a final round of testing to confirm that the recipient was infected with the virus from the donor’s lungs. Sequencing, He explained that it resembles a DNA sequence performed when analyzing a crime scene. “The sequencing showed that it was the same virus that spreads from donors to recipients to surgeons,” Cowl told Post.

Over the years, the woman’s condition worsened.Cowl’s team gave her all available treatments, including two rounds of remdesivir and convalescent plasma therapy. Twice, but her body became weak, the doctor said. She was placed in a bypass device to oxygenate the blood, but was amputated after it became clear that she would not maintain another lung transplant. She died 61 days after surgery.

Infected surgeon Then I recovered.

Mr. Cowl said his report provided important guidelines for doctors and organ donors.

“The lesson we have learned and strongly felt is that all lung donors need to check lower respiratory tract specimens,” said Cowl, who said about one in three lung donors before transplant surgery. He said that a person would undergo this type of examination.

According to Cowl, some laboratories lack experience other than nasal swab testing, but organ donation groups do not have enough time to perform the tests while the organs are still transplantable.

“We need to overcome these barriers and perform this test on all lungs,” Cowl said. “I chose to report this because I think it is very important that people in the transplant community are aware of this transmission. [respiratory] Tube specimens are checked on all lung donors. “

It is still unclear if organs other than the lungs are possible According to Cowl, you can send covid-19.

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