Evidence is mounting to show that organ donation from dying donors testing positive for SARS-CoV-2 appears to be safe and does not cause Covid-19 in the patient receiving the donated organ, according to a study. The Covid pandemic exacerbated the shortage of abdominal organs for donation by increasing organ discard rates, due to the unclear risks of using organs from Covid-19 infected donors. A team from Duke University in the US analysed six abdominal organ transplants performed (2 livers, 2 kidneys/pancreas transplanted together) in four recipients using organs procured from four donors who tested positive for Covid and died.

The donor evaluation protocol included additional review of organ quality, with all four donors undergoing macroscopic and/or microscopic biopsy review to confirm organ suitability.

Donors were assessed by considering organ type, the duration and severity of Covid-19 illness, whether any signs of hypercoagulable disease were present (meaning potentially increased clotting in the donated organ or vessels) as well as careful overall inspection at the time of organ procurement.

Further, if the organ to be donated was lung or intestine, it would only be considered if the donor last tested positive for Covid more than 20 days ago, a timeline consistent with infection control practices of the US Centers for Disease Control and Prevention (CDC).

And if the virus was found in the base of the lungs, the lungs were deemed unsuitable for transplantation, but other organs could still be transplanted safely, provided the donor was not dying from severe hyperinflammatory Covid-19 or showed signs of excessive clotting, the team explained.

Even after passing through all these barriers, doctors must still consider the ultimate cause of death for a donor and weigh up whether that is likely to negatively impact organ quality and/or surgical risk, they said.

Further, to reduce the transplant risk, recipients are now strongly encouraged to be fully Covid-19 vaccinated prior to surgery.      Source: IANS