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Heart transplantation from COVID-positive donors with 6-month follow-up: A case series
Christina Tran1, Anureet Malhotra2, Tarun Dalia3
1Medical Student, University of Kansas Medical Center, Kansas, USA.
Insights
Heart transplants from donors positive for Coronavirus disease 2019 (COVID-19) show acceptable long-term outcomes. Utilizing these donors may reduce waitlist mortality for heart transplant candidates.
Area of Science:
- Cardiology
- Transplantation Surgery
- Infectious Diseases
Background:
- Limited data exists on long-term outcomes for heart transplant recipients receiving organs from donors positive for Coronavirus disease 2019 (COVID-19).
- Assessing the viability of using COVID-19 positive donors is crucial given the critical shortage of donor organs.
Purpose of the Study:
- To evaluate the long-term outcomes of heart transplant recipients who received organs from COVID-19 positive donors.
- To determine if using COVID-19 positive donors impacts patient survival and graft function compared to traditional donor pools.
Main Methods:
- A retrospective analysis of nine heart transplant recipients who received organs from COVID-19 PCR-positive donors between November 2021 and August 2022.
- All recipients were vaccinated against COVID-19 and followed for a mean of 12.12 ± 3 months.
- Outcomes were compared to a control group receiving hearts from COVID-19 negative donors.
Main Results:
- Eight out of nine recipients (88.9%) had acceptable long-term outcomes.
- One patient died during the initial admission due to primary graft dysfunction.
- No significant difference in outcome parameters was observed compared to recipients of hearts from COVID-19 negative donors; notably, none of the surviving recipients contracted COVID-19 post-transplant.
Conclusions:
- Heart transplantation from COVID-19 positive donors can be considered to expand the donor pool.
- This approach may help reduce waitlist mortality for patients awaiting heart transplantation.
- Careful patient selection and management are essential for successful outcomes.
Background:
Data on long term outcomes in heart transplant recipients from Coronavirus disease 2019 (COVID-19) positive donors are limited.
Methods And Results:
We present a series of nine patients who underwent heart transplants from COVID-19 PCR-positive donors between November 2021 to August 2022 with mean follow-up of 12.12 ± 3 months. All the recipients received two doses of COVID-19 vaccine and had at least 6 months follow-up. Eight recipients had acceptable long-term outcomes; one patient died during index admission from primary graft dysfunction. Details regarding donor and recipient characteristics, management and outcomes are provided. Two patients developed deep vein thrombosis, and one patient underwent pacemaker implantation for sinus node dysfunction. Among the surviving eight patients, none developed COVID-19 infection during follow-up period. There was no significant difference in outcome parameters when compared to patients who received hearts from donors who tested negative for COVID-19 during the same time period at our center.
Conclusion:
Keeping in mind the significant waitlist mortality in patients awaiting heart transplantation, COVID-19-positive donors should be considered for heart transplantation to help expand the donor pool and potentially reduce waitlist mortality.
