Martinez-Reviejo R, Tejada S, Cipriano A, Nur Karakoc H, Manuel O, Rello J. Solid organ transplantation from donors with recent or current SARS-CoV-2 infection: A Systematic Review.
Anaesth Crit Care Pain Med 2022;
41:101098. [PMID:
35533977 PMCID:
PMC9074299 DOI:
10.1016/j.accpm.2022.101098]
[Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/28/2022] [Accepted: 04/28/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND
Solid-organ transplantation (SOT) from SARS-CoV-2 positive donors could be a life-saving opportunity worth grasping. We perform a systematic review of SOT using SARS-CoV-2 positive donors.
METHODS
The search was performed in PubMed, Cochrane COVID-19 Study Register, and Web of Science databases, including studies conducted till the 31th of December 2021 from SOT adult recipients from a donor with past or current SARS-CoV-2 infection. Outcomes were viral transmission, COVID-19 symptoms, mortality, hospital stay, and complications. PROSPERO Register Number: CRD42022303242 FINDINGS: Sixty-nine recipients received 48 kidneys, 18 livers and 3 hearts from 57 donors. Six additional transplants from positive lungs were identified. IgG + anti-SARS-CoV-2 titers were detected among 10/16 recipients; only 4% (3/69) recipients were vaccinated. Non-lung transplant recipients received organs from 10/57 (17.5%) donors with persistent COVID-19 and SARS-CoV-2 RNA was detected (median 32 Cycle threshold [Ct]) in 18/57, at procurement. Among non-lung transplant recipients, SARS-CoV-2 viral transmission was not documented. Four patients presented delayed graft dysfunction, two patients acute rejection, and two patients died of septic shock. The median (IQR) hospital stay was 18 (11-28) days in recipients from symptomatic donors. Viral transmission occurred from three lung donors to their recipients, who developed COVID-19 symptoms. One of the recipients subsequently died.
CONCLUSION
Use of non-lung (kidney, liver and heart) organs from SARS-CoV-2 positive donors seem to be a safe practice, with a low risk of transmission irrespective of the presence of symptoms at the time of procurement. Low viral replication (Ct > 30) was safe among non-lung donors, even if persistently symptomatic at procurement.
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