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Weiss MJ, Hornby L, Foroutan F, Belga S, Bernier S, Bhat M, Buchan CA, Gagnon M, Hardman G, Ibrahim M, Luo C, Luong ML, Mainra R, Manara AR, Sapir-Pichhadze R, Shalhoub S, Shaver T, Singh JM, Srinathan S, Thomas I, Wilson LC, Wilson TM, Wright A, Mah A. Clinical Practice Guideline for Solid Organ Donation and Transplantation During the COVID-19 Pandemic. Transplant Direct 2021; 7:e755. [PMID: 34514110 PMCID: PMC8425831 DOI: 10.1097/txd.0000000000001199] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 12/15/2022] Open
Abstract
The coronavirus 2019 (COVID-19) pandemic has disrupted health systems worldwide, including solid organ donation and transplantation programs. Guidance on how best to screen patients who are potential organ donors to minimize the risks of COVID-19 as well as how best to manage immunosuppression and reduce the risk of COVID-19 and manage infection in solid organ transplant recipients (SOTr) is needed. METHODS Iterative literature searches were conducted, the last being January 2021, by a team of 3 information specialists. Stakeholders representing key groups undertook the systematic reviews and generation of recommendations using a rapid response approach that respected the Appraisal of Guidelines for Research and Evaluation II and Grading of Recommendations, Assessment, Development and Evaluations frameworks. RESULTS The systematic reviews addressed multiple questions of interest. In this guidance document, we make 4 strong recommendations, 7 weak recommendations, 3 good practice statements, and 3 statements of "no recommendation." CONCLUSIONS SOTr and patients on the waitlist are populations of interest in the COVID-19 pandemic. Currently, there is a paucity of high-quality evidence to guide decisions around deceased donation assessments and the management of SOTr and waitlist patients. Inclusion of these populations in clinical trials of therapeutic interventions, including vaccine candidates, is essential to guide best practices.
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Affiliation(s)
- Matthew J Weiss
- Transplant Québec, Montréal, QC, Canada
- CHU de Québec - Université Laval Research Center, Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Université Laval, QC, Canada
- Canadian Donation and Transplantation Research Program (CDTRP), Ottawa, ON, Canada
| | - Laura Hornby
- Canadian Donation and Transplantation Research Program (CDTRP), Ottawa, ON, Canada
- System Development - Organ and Tissue Donation and Transplantation, Canadian Blood Services, Ottawa, ON, Canada
| | - Farid Foroutan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, Toronto, ON, Canada
| | - Sara Belga
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Mamatha Bhat
- Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Multiorgan Transplant Program, University Health Network, University of Toronto, Toronto, ON, Canada
| | - C Arianne Buchan
- Division of Infectious Diseases, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Michael Gagnon
- Division of Nephrology and Multi-Organ Transplant Program, Department of Medicine, McGill University, Montreal, QC, Canada
| | - Gillian Hardman
- National Health Service Blood and Transplant, Bristol, United Kingdom
| | - Maria Ibrahim
- National Health Service Blood and Transplant, Bristol, United Kingdom
- Kings College, London, United Kingdom
| | - Cindy Luo
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Me-Linh Luong
- Department of Microbiology, Infectiology and Immunology, Université de Montréal, Montréal, QC, Canada
| | - Rahul Mainra
- Division of Nephrology, University of Saskatchewan, Saskatoon, SK, Canada
- St. Paul's Hospital, Saskatchewan Transplant Program, Saskatoon, SK, Canada
| | - Alex R Manara
- National Health Service Blood and Transplant, Bristol, United Kingdom
- Department of Intensive Care Medicine, Southmead Hospital, Bristol, United Kingdom
| | - Ruth Sapir-Pichhadze
- Division of Nephrology and Multi-Organ Transplant Program, Department of Medicine, McGill University, Montreal, QC, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of McGill University Health Centre, Montreal, QC, Canada
| | - Sarah Shalhoub
- Division of Infectious Diseases, Department of Medicine, Western University, London, ON, Canada
| | - Tina Shaver
- Southern Alberta Organ and Tissue Donation Program, Calgary, AB, Canada
| | - Jeffrey M Singh
- Department of Medicine, University of Toronto, Toronto, Ontario, ON, Canada
- Trillium Gift of Life Network, Toronto, ON, Canada
| | - Sujitha Srinathan
- Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ian Thomas
- National Health Service Blood and Transplant, Bristol, United Kingdom
- Department of Intensive Care Medicine, Southmead Hospital, Bristol, United Kingdom
| | - Lindsay C Wilson
- System Development - Organ and Tissue Donation and Transplantation, Canadian Blood Services, Ottawa, ON, Canada
| | - T Murray Wilson
- Transplant Research Foundation of British Columbia, Vancouver, BC, Canada
- Patient Partner, Canadian Donation and Transplantation Research Program
- The Alberta ORGANization Group, Edmonton, AB, Canada
| | - Alissa Wright
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Allison Mah
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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Ungerman E, Jayaraman AL, Patel B, Khoche S, Subramanian H, Bartels S, Knight J, Gelzinis TA. The Year in Cardiothoracic Transplant Anesthesia: Selected Highlights From 2020 Part II: Cardiac Transplantation. J Cardiothorac Vasc Anesth 2021; 36:390-402. [PMID: 34657796 DOI: 10.1053/j.jvca.2021.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Elizabeth Ungerman
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Arun L Jayaraman
- Department of Anesthesiology and Perioperative Medicine, Department of Critical Care Medicine, Mayo Clinic, Rochester, MN
| | - Bhoumesh Patel
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT
| | - Swapnil Khoche
- Department of Anesthesiology, University of California, San Diego, CA
| | - Harikesh Subramanian
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Steven Bartels
- Department of Anesthesiology and Perioperative Medicine, Loyola University Medical Center, Maywood, IL
| | - Joshua Knight
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA
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