Some vital organs from patients who died from COVID-19 infection do not have evidence of the virus and can still be used for transplants, researchers from Johns Hopkins University said Monday.
After a donor died of complications related to COVID-19, one of their kidneys was successfully transplanted into another patient, according to the researchers. Before the transplant, “careful collection and sensitive molecular testing of the donor organ for evidence of the virus,” was conducted.
Testing demonstrated that the organ was safe to transplant, according to a summary for a peer-reviewed publication. Some autopsies have found high levels of virus receptors in kidneys, which indicates they could be a target area for COVID-19. These findings caused concern about using donor kidneys from COVID-19 patients, researchers explained.
Investigators from Johns Hopkins said this is the first documented case of a COVID-19 kidney transplant that included analysis of samples with sophisticated tools that can detect molecular evidence of the novel coronavirus, including the in situ hybridization laboratory technique. However, kidneys from deceased patients who were infected with the virus have been successfully used for transplants before.
“Instead of just doing a nasal swab test on the recipient after the transplant to check for infection after the fact, we obtained the donor kidney tissue prior to transplant and studied it carefully,” said Kyungho Lee, M.D., a Johns Hopkins Medicine fellow
According to Johns Hopkins Medicine, the donor was a woman in her early 30s who was otherwise healthy. She was admitted to the hospital in March 2021 due to severe COVID-19 pneumonia and was eventually placed on extracorporeal membrane oxygenation (ECMO), a blood pump outside the body that provides oxygen.
The woman then developed hypoxic brain injury due to a lack of oxygen which later progressed to brain death. Her kidney function remained stable throughout her hospitalization and she tested negative for COVID-19 by nasal swab three days before the donation.
A 55-year-old man with end-stage kidney disease received the donor’s kidney within 24 hours of her death. He had been on dialysis for more than five years, no history of COVID-19 infection and was fully vaccinated.
On the day of the transplant, he tested negative for the virus.
He also tested negative, 20, 30 and 90 days after the transplant procedure and has shown no signs or symptoms of COVID-19.
Additionally, the patient has been off dialysis and has excellent kidney function, researchers said.
“We know our case may not be representative of many possible COVID-19 donors, particularly since the donor was negative for COVID-19 at the time of transplantation,” said Hamid Rabb, M.D., medical director of the Johns Hopkins Kidney Transplant Program. “However, it’s a step forward using highly sensitive molecular testing to show it can be safe to use organs from deceased COVID-19 donors. Organs can be individually considered for kidney transplant instead of being routinely discarded.”
According to Rabb, decisions on whether to accept organs other than lungs from donors who have died from COVID-19-related causes should be made on a case-by-case basis.
Around 106,000 Americans are currently waiting for donor organs, U.S.
Department of Health and Human Services data indicates. Each year, approximately 9,000 patients who need a kidney die before they are able to receive a transplant or experience such severe health deterioration that they are removed from the transplant list.
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