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Utilization of deceased donors during a pandemic: argument against using SARS-CoV-2-positive donors
Malay B Shah1, Raymond J Lynch2, Hanine El-Haddad3
1Department of Surgery, Division of Abdominal Transplant Surgery, University of Kentucky College of Medicine, Lexington, Kentucky, USA.
Abstract:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly become an unprecedented pandemic that has impacted society, disrupted hospital functions, strained health care resources, and impacted the lives of transplant professionals. Despite this, organ failure and the need for transplant continues throughout the United States. Considering the perpetual scarcity of deceased donor organs, Kates et al present a viewpoint that advocates for the utilization of coronavirus disease 2019 (COVID-19)-positive donors in selected cases. We present a review of the current literature that details the potential negative consequences of COVID-19-positive donors. The factors we consider include (1) the risk of blood transmission of SARS-CoV-2, (2) involvement of donor organs, (3) lack of effective therapies, (4) exposure of health care and recovery teams, (5) disease transmission and propagation, and (6) hospital resource utilization. While we acknowledge that transplant fulfills the mission of saving lives, it is imperative to consider the consequences not only to our recipients but also to the community and to health care workers, particularly in the absence of effective preventative or curative therapies. For these reasons, we believe the evidence and risks show that COVID-19 infection should continue to remain a contraindication for donation, as has been the initial response of donation and transplant societies.
Insights
Using deceased donors with COVID-19 for organ transplantation poses significant risks. Current evidence suggests COVID-19 infection should remain a contraindication for organ donation to protect recipients and healthcare workers.
Area of Science:
- Transplantation Medicine
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic has strained healthcare systems globally.
- Organ transplantation continues to be essential despite the pandemic.
- Deceased donor organ scarcity necessitates exploring all potential sources.
Purpose of the Study:
- To review the potential negative consequences of utilizing COVID-19-positive donors for organ transplantation.
- To evaluate the risks associated with SARS-CoV-2 transmission from donors to recipients and healthcare personnel.
- To inform the ongoing debate on organ donation policies during the COVID-19 pandemic.
Main Methods:
- Literature review of current scientific evidence.
- Analysis of potential risks including viral transmission, organ involvement, and healthcare resource impact.
- Consideration of ethical implications and patient safety.
Main Results:
- Potential for SARS-CoV-2 blood transmission exists.
- Donor organs may be involved, posing a risk to recipients.
- Lack of effective therapies increases recipient vulnerability.
- Exposure risks for healthcare and recovery teams are significant.
- Concerns regarding disease propagation and hospital resource utilization.
Conclusions:
- The risks associated with using COVID-19-positive donors currently outweigh the benefits.
- COVID-19 infection should remain a contraindication for organ donation.
- Protecting recipients, healthcare workers, and the community is paramount, especially without effective treatments.
