Heart Transplantation from COVID-19-Positive Donors: A Word of Caution.

Authors :: Castro-Varela A
Gallego-Navarro C
Bhaimia E
Gupta A
Spencer PJ
Daly RC
Clavell AL
Knop GL
Maleszewski JJ
Villavicencio MA
Cummins NW
Source :: Transplantation proceedings [Transplant Proc] 2023 Apr; Vol. 55 (3), pp. 533-539. Date of Electronic Publication: 2023 Mar 03.
Publication Year :: 2023
Abstract: Background: During the COVID-19 pandemic, efforts to maintain solid-organ transplantation have continued, including the use of SARS-CoV-2-positive heart donors.<br />Methods: We present our institution's initial experience with SARS-CoV-2-positive heart donors. All donors met our institution's Transplant Center criteria, including a negative bronchoalveolar lavage polymerase chain reaction result. All but 1 patient received postexposure prophylaxis with anti-spike monoclonal antibody therapy, remdesivir, or both.<br />Results: A total of 6 patients received a heart transplant from a SARS-CoV-2-positive donor. One heart transplant was complicated by catastrophic secondary graft dysfunction requiring venoarterial extracorporeal membrane oxygenation and retransplant. The remaining 5 patients did well postoperatively and were discharged from the hospital. None of the patients had evidence of COVID-19 infection after surgery.<br />Conclusion: Heart transplants from SARS-CoV-2 polymerase chain reaction-positive donors are feasible and safe with adequate screening and postexposure prophylaxis.<br /> (Copyright © 2023 Elsevier Inc. All rights reserved.)