Use of SARS-CoV-2-infected deceased organ donors: Should we always "just say no?"
Betacoronavirus
COVID-19
Coronavirus Infections
/ prevention & control
Ethics, Medical
Heart
/ virology
Heart Transplantation
/ adverse effects
Humans
Liver
/ virology
Liver Transplantation
/ adverse effects
Lung
/ virology
Occupational Exposure
Pandemics
/ prevention & control
Pneumonia, Viral
/ prevention & control
SARS-CoV-2
Severe Acute Respiratory Syndrome
/ prevention & control
Tissue Donors
Tissue and Organ Procurement
/ ethics
Waiting Lists
donors and donation: deceased
donors and donation: donor-derived infections
editorial/personal viewpoint
ethics
ethics and public policy
infection and infectious agents - viral
infectious disease
organ acceptance
organ procurement and allocation
organ transplantation in general
Journal
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
ISSN: 1600-6143
Titre abrégé: Am J Transplant
Pays: United States
ID NLM: 100968638
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
20
03
2020
revised:
20
04
2020
accepted:
01
05
2020
pubmed:
14
5
2020
medline:
21
7
2020
entrez:
14
5
2020
Statut:
ppublish
Résumé
In the context of a rapidly evolving pandemic, multiple organizations have released guidelines stating that all organs from potential deceased donors with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection should be deferred, including from otherwise medically eligible donors found to have mild or asymptomatic SARS-CoV-2 discovered on routine donor screening. In this article, we critically examine the available data on the risk of transmission of SARS-CoV-2 through organ transplantation. The isolation of SARS-CoV-2 from nonlung clinical specimens, the detection of SARS-CoV-2 in autopsy specimens, previous experience with the related coronaviruses SARS-CoV and MERS-CoV, and the vast experience with other common RNA respiratory viruses are all addressed. Taken together, these data provide little evidence to suggest the presence of intact transmissible SARS-CoV in organs that can potentially be transplanted, specifically liver and heart. Other considerations including ethical, financial, societal, and logistical concerns are also addressed. We conclude that, for selected patients with high waitlist mortality, transplant programs should consider accepting heart or liver transplants from deceased donors with SARS-CoV-2 infection.
Identifiants
pubmed: 32400087
doi: 10.1111/ajt.16000
pmc: PMC7272824
pii: S1600-6135(22)22413-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1787-1794Subventions
Organisme : NHLBI NIH HHS
ID : K23 HL143050
Pays : United States
Organisme : NIAID NIH HHS
ID : T32 AI118690
Pays : United States
Informations de copyright
© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.
Références
Am J Pathol. 2016 Mar;186(3):507-10
pubmed: 26724388
Lancet Respir Med. 2020 Apr;8(4):420-422
pubmed: 32085846
Transfus Apher Sci. 2007 Dec;37(3):233-40
pubmed: 18036985
JAMA. 2020 Apr 7;323(13):1243-1244
pubmed: 32077901
Histopathology. 2018 Feb;72(3):516-524
pubmed: 28858401
Transplantation. 2012 Mar 15;93(5):551-4
pubmed: 22245874
Circ Heart Fail. 2018 Apr;11(4):e004586
pubmed: 29666073
J Hosp Infect. 2020 May;105(1):102-103
pubmed: 32142886
Int J Antimicrob Agents. 2014 Dec;44(6):528-32
pubmed: 25288266
Lancet Gastroenterol Hepatol. 2020 May;5(5):428-430
pubmed: 32145190
Infect Control Hosp Epidemiol. 2020 May;41(5):493-498
pubmed: 32131908
Herz. 2020 May;45(3):230-232
pubmed: 32140732
J Pathol. 2004 Jun;203(2):622-30
pubmed: 15141376
Transfusion. 2007 Jun;47(6):1080-8
pubmed: 17524100
Transplantation. 2015 Feb;99(2):282-7
pubmed: 25594557
Eur J Clin Invest. 2009 Jul;39(7):618-25
pubmed: 19453650
Am J Transplant. 2011 Jun;11(6):1123-30
pubmed: 21443676
Gastroenterology. 2003 Oct;125(4):1011-7
pubmed: 14517783
Sci Adv. 2017 Nov 15;3(11):eaao4966
pubmed: 29152574
Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Feb 10;41(2):145-151
pubmed: 32064853
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
J Infect. 2020 Apr;80(4):401-406
pubmed: 32112886
Influenza Other Respir Viruses. 2019 Jul;13(4):398-406
pubmed: 29144593
Hepatol Int. 2016 Sep;10(5):838-46
pubmed: 27221700
Am J Transplant. 2009 Aug;9(8):1929-35
pubmed: 19538493
Clin Infect Dis. 2013 Dec;57(12):1731-41
pubmed: 24065324
Am J Clin Pathol. 2011 Sep;136(3):416-23
pubmed: 21846917
Cell. 2020 Apr 16;181(2):223-227
pubmed: 32220310
Chin Med J (Engl). 2020 May 5;133(9):1039-1043
pubmed: 32118639