Related Experiment Video
Updated: Aug 15, 2025
A High-Fidelity Porcine Model of Orthotopic Heart Transplantation Following Donation after Circulatory Death
Published on: June 6, 2025
Utilization of COVID-19 positive donors for Heart transplantation and associated short-term outcomes
Ersilia M DeFilippis1, Brian Wayda2, Anuradha Lala3
1Division of Cardiology, Columbia University Irving Medical Center, New York, New York.
Insights
Carefully selected heart donors positive for COVID-19 can be used for heart transplantation (HT) without impacting short-term outcomes. This study found no significant differences in post-transplant survival or graft failure between recipients of COVID-19 positive versus negative donors.
Area of Science:
- Cardiology
- Transplantation Immunology
- Infectious Diseases
Background:
- The use of donors positive for COVID-19 in heart transplantation (HT) is a growing concern with limited established safety and efficacy data.
- This study investigates the characteristics of such donors and their impact on post-HT outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of using COVID-19 positive donors for heart transplantation.
- To compare outcomes between heart transplant recipients who received organs from COVID-19 positive versus COVID-19 negative donors.
Main Methods:
- A retrospective analysis of adult heart donors and recipients in the United States from April 2020 to March 2022.
- Donor COVID-19 status was determined by positive tests within 21 days of organ recovery.
- Outcomes, including death, graft failure, and re-transplantation, were compared based on donor COVID-19 status.
Main Results:
- Fewer COVID-19 positive donors (19.3%) were utilized for HT compared to COVID-19 negative donors (26.7%).
- Recipients of COVID-19 positive donor hearts received less pre-HT inotropes and ventricular assist device therapy.
- No significant differences were observed in 90-day post-HT outcomes, including the composite endpoint of death, graft failure, or re-transplantation, between the two donor groups.
Conclusions:
- Carefully selected COVID-19 positive donors can be safely used for heart transplantation, showing no difference in short-term outcomes.
- Further research is needed to collect data on donor/recipient treatments and vaccination impact to optimize the use of organs from COVID-19 positive donors.
Background:
The safety and efficacy of using COVID-19 positive donors in heart transplantation (HT) are increasingly relevant, but not well established. The present study evaluated the characteristics and utilization of such donors and associated post-HT outcomes.
Methods:
All adult (≥18 years old) potential donors and HT recipients in the United States from April 21, 2020 to March 31, 2022 were included. Donor COVID-19 status was defined by the presence (or absence) of any positive test within 21 days of organ recovery. Donor and recipient characteristics and post-HT outcomes, including a primary composite of death, graft failure, and re-transplantation, were compared by donor COVID-19 status.
Results:
Of 967 COVID-19(+) potential donors, 19.3% (n = 187) were used for HT compared to 26.7% (n = 6277) of COVID-19(-) donors (p < 0.001). Transplanted COVID-19(+) vs COVID-19(-) donors were younger, but otherwise were similar. Recipients of hearts from COVID-19+ vs COVID-19(-) donors less frequently received pre-HT inotropes (24.1% vs 31.7%, p = 0.023) and ventricular assist device therapy (29.7% vs 36.8%, p = 0.040). There were no significant differences in any post-HT outcome by donor COVID-19 status, including the primary composite outcome at 90 days (5.4% vs 5.6%, p = 0.91). Among COVID-19(+) donors, the presence of a subsequent negative test prior to transplant was not associated with posttransplant outcomes.
Conclusions:
Our results suggest that carefully selected COVID-19 positive donors may be used for HT with no difference in short-term post-transplant outcomes. Additional data regarding donor and recipient treatments and impact of vaccination should be collected to better inform our use of organs from COVID(+) donors.
