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新冠病毒感染后的肺脏捐献。

Lung donation following SARS-CoV-2 infection.

机构信息

Division of Thoracic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

Division of Pulmonary and Critical Care Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

出版信息

Am J Transplant. 2021 Dec;21(12):4073-4078. doi: 10.1111/ajt.16777. Epub 2021 Aug 9.


DOI:10.1111/ajt.16777
PMID:34332512
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8441925/
Abstract

There have been over 177 million cases of COVID-19 worldwide, many of whom could be organ donors. Concomitantly, there is an anticipated increase in the need for donor lungs due to expanding indications. Given that the respiratory tract is most commonly affected by COVID-19, there is an urgent need to develop donor assessment criteria while demonstrating safety and "efficacy" of lung donation following COVID-19 infection. Accordingly, we report an intentional transplant using lungs from a donor with recent, microbiologically confirmed, COVID-19 infection into a recipient suffering from COVID-19 induced ARDS and pulmonary fibrosis. In addition to the standard clinical assays, both donor and recipient lungs were analyzed using RNAscope, which confirmed that tissues were negative for SARS-CoV-2. Immunohistochemistry demonstrated colocalized KRT17+ basaloid-like epithelium and COL1A1+ fibroblasts, a marker suggestive of lung fibrosis in COVID-19 associated lung disease, in the explanted recipient lungs but absent in the donor lungs. We demonstrate that following a thorough assessment, lung donation following resolved COVID-19 infection is safe and feasible.

摘要

全球已有超过 1.77 亿例 COVID-19 病例,其中许多人可能是器官捐献者。同时,由于适应症的扩大,预计对供体肺的需求将会增加。鉴于 COVID-19 主要影响呼吸道,因此迫切需要制定供体评估标准,并在 COVID-19 感染后证明肺捐献的安全性和“疗效”。因此,我们报告了一例使用最近经微生物学确认患有 COVID-19 的供体的肺进行移植,受者患有 COVID-19 诱导的急性呼吸窘迫综合征和肺纤维化。除了标准的临床检测外,还使用 RNAscope 对供体和受体的肺进行了分析,结果证实组织中没有 SARS-CoV-2。免疫组织化学显示,在移植受体的肺中存在 COL1A1+成纤维细胞和 KRT17+基底样上皮细胞的共定位,这是 COVID-19 相关肺部疾病中肺纤维化的标志物,但在供体肺中不存在。我们证明,在经过彻底评估后,COVID-19 感染后进行肺捐献是安全可行的。

相似文献

[1]
Lung donation following SARS-CoV-2 infection.

Am J Transplant. 2021-12

[2]
Donor to recipient transmission of SARS-CoV-2 by lung transplantation despite negative donor upper respiratory tract testing.

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[3]
COVID-19 positive donor for solid organ transplantation.

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[4]
[The impact of the COVID‒19 pandemic on organ donation and transplantation in Hungary in 2020].

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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
COVID-19 seropositive donors yield comparable post-lung transplant outcomes.

J Thorac Dis. 2024-7-30

[2]
Lung Transplantation for Coronavirus Disease-2019 Patients and Coronavirus Disease-2019 in Lung Transplant Recipients.

Clin Chest Med. 2023-3

[3]
Successful lung transplantation using an allograft from a COVID-19-recovered donor: a potential role for subgenomic RNA to guide organ utilization.

Am J Transplant. 2023-1

[4]
Organ transplantation using COVID-19-positive deceased donors.

Am J Transplant. 2022-9

[5]
How COVID-19 Affects Lung Transplantation: A Comprehensive Review.

J Clin Med. 2022-6-18

[6]
Solid organ transplantation from donors with recent or current SARS-CoV-2 infection: A systematic review.

Anaesth Crit Care Pain Med. 2022-8

[7]
Lung donation and SARS-CoV-2 transmission: Missed detection versus missed opportunity?

Immun Inflamm Dis. 2022-4

[8]
Use of Organs from SARS-CoV-2 Infected Donors: Is It Safe? A Contemporary Review.

Curr Transplant Rep. 2021

本文引用的文献

[1]
Early success transplanting kidneys from donors with new SARS-CoV-2 RNA positivity: A report of 10 cases.

Am J Transplant. 2021-11

[2]
Early outcomes after lung transplantation for severe COVID-19: a series of the first consecutive cases from four countries.

Lancet Respir Med. 2021-5

[3]
A call to routinely test lower respiratory tract samples for SARS-CoV-2 in lung donors.

Am J Transplant. 2021-7

[4]
Donor to recipient transmission of SARS-CoV-2 by lung transplantation despite negative donor upper respiratory tract testing.

Am J Transplant. 2021-8

[5]
Circuits between infected macrophages and T cells in SARS-CoV-2 pneumonia.

Nature. 2021-2

[6]
Successful double-lung transplantation from a donor previously infected with SARS-CoV-2.

Lancet Respir Med. 2021-3

[7]
Lung transplantation for patients with severe COVID-19.

Sci Transl Med. 2020-11-30

[8]
Chest Computed Tomography Findings in Asymptomatic Patients with COVID-19.

Respiration. 2020

[9]
Imaging findings in coronavirus infections: SARS-CoV, MERS-CoV, and SARS-CoV-2.

Br J Radiol. 2020-7-6

[10]
SARS-CoV-2: The viral shedding vs infectivity dilemma.

Infect Dis Health. 2020-8

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