Transplant of organs from SARS-CoV-2-positive donors safe, finds study

Transplantation of organs from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid test (NAT)-positive donors seems safe for short-term outcomes, according to a study published online Jan. 24 in Transplant Infectious Disease.

Jason D. Goldman, M.D., from the Swedish Medical Center in Seattle, and colleagues compared organ utilization and recipient outcomes between SARS-CoV-2 NAT-positive and NAT-negative donors. Organs were recovered from 617 NAT-positive donors from all Organ Procurement and Transplantation Network regions and 53 of 57 organ procurement organizations from May 27, 2021, to Jan. 31, 2022.

The researchers found that NAT-positive donors were younger, with higher organ quality scores for kidney and liver. Compared with NAT-negative donors, NAT-positive donors had lower organ utilization. Overall, 1,241 organs were transplanted from 514 NAT-positive donors compared with 21,946 organs from 8,853 NAT-negative donors.

Recipients of NAT-positive liver and heart transplants had lower medical urgency. Liver recipients of NAT-positive donors had a longer median wait-list time. For all organ types, the match run sequence number for final acceptor was higher for NAT-positive donors. For all organ types, outcomes for hospital length of stay, 30-day mortality, and 30-day graft loss were similar. There were no SARS-CoV-2 donor-derived transmission events reported in this study period.

"These data suggest that the careful use of SARS-CoV-2 NAT+ donors can balance the risk for waitlist mortality in the setting of scarcity of available deceased donor organs," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.