Utilization of SARS-CoV-2-Positive donors in pediatric renal transplantation.
COVID-19
cycle threshold
infection
outcomes
renal function
Journal
Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
revised:
12
08
2022
received:
26
05
2022
accepted:
24
10
2022
medline:
24
7
2023
pubmed:
16
12
2022
entrez:
15
12
2022
Statut:
ppublish
Résumé
As COVID-19-positive donors are becoming more common, there is an increasing need for the transplant community to evaluate the safety and efficacy of organ transplant from a SARS-CoV-2-infected donor. Here we describe outcomes of two pediatric kidney transplant recipients who were vaccinated against COVID-19 and received their allograft from a SARS-CoV-2-positive donor. Both donors did not die from a COVID-19-related illness; the first donor had 1 week of COVID-19 symptoms 4 weeks prior to donation and the second was asymptomatic. Donor 1 had a Ct of 33.4 at 3 days and Donor 2 with a Ct of 37.2 at 16 days prior to donation. The first recipient was positive for SARS-CoV-2 anti-spike IgG on the day of transplant, but the second patient was negative and both patients received IVIg perioperatively. There was no evidence of SARS-CoV-2 transmission or compromised renal function at 86- and 80-day post-transplant, respectively. This case series suggests favorable short-term outcomes with accepting SARS-CoV-2-positive donors for pediatric renal transplantation, after thorough evaluation of the donor's risk for transmission, assessing the recipient's serologic status to SARS-CoV-2, and considering pre-emptive measures to mitigate the risk for severe COVID-19 should the recipient acquire donor-derived SARS-CoV-2.
Sections du résumé
BACKGROUND
As COVID-19-positive donors are becoming more common, there is an increasing need for the transplant community to evaluate the safety and efficacy of organ transplant from a SARS-CoV-2-infected donor.
METHODS
Here we describe outcomes of two pediatric kidney transplant recipients who were vaccinated against COVID-19 and received their allograft from a SARS-CoV-2-positive donor.
RESULTS
Both donors did not die from a COVID-19-related illness; the first donor had 1 week of COVID-19 symptoms 4 weeks prior to donation and the second was asymptomatic. Donor 1 had a Ct of 33.4 at 3 days and Donor 2 with a Ct of 37.2 at 16 days prior to donation. The first recipient was positive for SARS-CoV-2 anti-spike IgG on the day of transplant, but the second patient was negative and both patients received IVIg perioperatively. There was no evidence of SARS-CoV-2 transmission or compromised renal function at 86- and 80-day post-transplant, respectively.
CONCLUSIONS
This case series suggests favorable short-term outcomes with accepting SARS-CoV-2-positive donors for pediatric renal transplantation, after thorough evaluation of the donor's risk for transmission, assessing the recipient's serologic status to SARS-CoV-2, and considering pre-emptive measures to mitigate the risk for severe COVID-19 should the recipient acquire donor-derived SARS-CoV-2.
Identifiants
pubmed: 36518031
doi: 10.1111/petr.14451
pmc: PMC9878121
doi:
Substances chimiques
Immunoglobulin G
0
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14451Informations de copyright
© 2022 Wiley Periodicals LLC.
Références
Schwartz GJ, Munoz A, Schneider MF, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol. 2009;20(3):629-637.
Gaussen A, Hornby L, Rockl G, et al. Evidence of SARS-CoV-2 infection in cells, tissues, and organs and the risk of transmission through transplantation. Transplantation. 2021;105(7):1405-1422.
Perlin DV, Dymkov IN, Terentiev AV, Perlina AV. Is kidney transplantation from a COVID-19-positive deceased donor safe for the recipient? Transplant Proc. 2021;53(4):1138-1142.
Summary of Current Evidence and Information. Donor SARS-CoV-2 testing & organ recovery from donors with a history of COVID-19 organ procurement and transplantation network. 2022. https://optn.transplant.hrsa.gov/media/kkhnlwah/sars-cov-2-summary-of-evidence.pdf. Accessed April 26, 2022.
Kute VB, Godara S, Guleria S, et al. Is it safe to Be transplanted from living donors who recovered from COVID-19? Experience of 31 kidney transplants in a multicenter cohort study from India. Transplantation. 2021;105(4):842-850.
Koval CE, Poggio ED, Lin YC, Kerr H, Eltemamy M, Wee A. Early success transplanting kidneys from donors with new SARS-CoV-2 RNA positivity: a report of 10 cases. Am J Transplant. 2021;21(11):3743-3749.
Puodziukaite L, Serpytis M, Kundrotaite A, et al. Kidney transplantation from a SARS-CoV-2-positive donor for the recipients with immunity after COVID-19. Transpl Infect Dis. 2021;23(4):e13666.
Sigler R, Shah M, Schnickel G, et al. Successful heart and kidney transplantation from a deceased donor with PCR positive COVID-19. Transpl Infect Dis. 2021;23(5):e13707.
La Hoz RM, Mufti AR, Vagefi PA. Short-term liver transplant outcomes from SARS-CoV-2 lower respiratory tract NAT positive donors. Transpl Infect Dis. 2022;24(1):e13757.
Manzia TM, Gazia C, Lenci I, et al. Liver transplantation performed in a SARS-CoV-2 positive hospitalized recipient using a SARS-CoV-2 infected donor. Am J Transplant. 2021;21(7):2600-2604.
Barros N, Ermel A, Mihaylov P, Lacerda M, Fridell J, Kubal C. Deceased donor liver transplantation from a SARS-CoV-2-positive donor to a SARS-CoV-2-positive recipient. Liver Transpl. 2021;27(12):1849-1851.
Romagnoli R, Gruttadauria S, Tisone G, et al. Liver transplantation from active COVID-19 donors: a lifesaving opportunity worth grasping? Am J Transplant. 2021;21(12):3919-3925.
de la Villa S, Valerio M, Salcedo M, et al. Heart and liver transplant recipients from donor with positive SARS-CoV-2 RT-PCR at time of transplantation. Transpl Infect Dis. 2021;23(5):e13664.
Molnar MZ, Hall IE, Raghavan D, et al. Kidney transplantation from SARS-CoV-2-positive deceased donor. Am J Transplant. 2022;22(4):1280-1282.
Frequently asked questions about coronavirus (COVID-19) for laboratories. 2021. https://www.cdc.gov/coronavirus/2019-ncov/lab/faqs.html#Interpreting-Results-of-Diagnostic-Tests. Accessed November 12, 2021.
Raveh Y, Simkins J, Vianna R, Tekin A, Nicolau-Raducu R. A less restrictive policy for liver transplantation in coronavirus disease 2019 positive patients, based upon cycle threshold values. Transplant Proc. 2021;53(4):1126-1131.
Andrews N, Stowe J, Kirsebom F, et al. Covid-19 vaccine effectiveness against the omicron (B.1.1.529) variant. N Engl J Med. 2022;386(16):1532-1546.
Heldman MR, Kates OS, Safa K, et al. Changing trends in mortality among solid organ transplant recipients hospitalized for COVID-19 during the course of the pandemic. Am J Transplant. 2022;22(1):279-288.
Cochran W, Shah P, Barker L, et al. COVID-19 clinical outcomes in solid organ transplant recipients during the omicron surge. Transplantation. 2022;106(7):e346-e347.
Garcia-Beltran WF, St Denis KJ, Hoelzemer A, et al. mRNA-based COVID-19 vaccine boosters induce neutralizing immunity against SARS-CoV-2 omicron variant. Cell. 2022;185(3):457-66 e4.
Kumar D, Hu Q, Samson R, et al. Neutralization against omicron variant in transplant recipients after three doses of mRNA vaccine. Am J Transplant. 2022;22(8):2089-2093.
Tarke A, Coelho CH, Zhang Z, et al. SARS-CoV-2 vaccination induces immunological T cell memory able to cross-recognize variants from alpha to omicron. Cell. 2022;185(5):847-59 e11.
Pfizer. Pfizer and BioNTech complete submission to European Medicines Agency for Omicron BA.1 adapted bivalent vaccine candidate 2022. https://www.pfizer.com/news/announcements/pfizer-and-biontech-complete-submission-european-medicines-agency-omicron-ba1. Accessed July 19, 2022.
Jordan SC, Berg A, Shin B, Vo A, Ammerman N, Zhang R. Intravenous immunoglobulin contains high-titer neutralizing IgG antibodies to SARS-CoV-2. Am J Transplant. 2022;22:2484-2485.
Levine DJ, Glanville AR, Aboyoun C, et al. Antibody-mediated rejection of the lung: a consensus report of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2016;35(4):397-406.