Kute Vivek B, Fleetwood Vidya A, Meshram Hari Shankar, Guenette Alexis, Lentine Krista L
Department of Nephrology, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Civil Hospital Campus, Asarwa, Ahmedabad, India.
Center for Abdominal Transplantation, Saint Louis University School of Medicine, Saint Louis, MO USA.
Curr Transplant Rep. 2021;8(4):281-292. doi: 10.1007/s40472-021-00343-0. Epub 2021 Oct 26.
As the prevalence of individuals with recovered coronavirus disease 2019 (COVID-19) increases, determining if and when organs from these donors can be safely used is an important priority. We examined current knowledge of outcomes of transplant using donors with recovered COVID-19.
A literature search of PubMed and Google scholar databases was conducted to identify articles with terms "SARS-CoV2," "COVID-19," "donor recovered," and "transplantation" published through 08/10/2021. We identified 25 reports detailing 94 recipients of both abdominal and thoracic transplants from donors with both prior and active COVID-19 infection. Rates of transmission to the recipient and of transplanted organ dysfunction were low among reports of donors with prior COVID-19 infection. End organ dysfunction and transmission were more common with active infection, although few reports are available. Standardized reporting is needed to better assess the impact of donor symptomatology, cycle thresholds, and individual recipient risk factors on postoperative outcomes.
Available reports suggest that transplantation from COVID-19 donors may be feasible and safe, at least in short term follow-up. Nevertheless, there is a need for standardized testing and management protocols which should be tailored for available resources. While increased availability of COVID-19 vaccinations will mitigate risks of donor-derived COVID-19 and simplify management, continued vigilance is warranted during the ongoing public health emergency.
随着新冠病毒病2019（COVID-19）康复者数量的增加，确定这些供体的器官能否以及何时可以安全使用是一项重要的优先事项。我们研究了目前关于使用COVID-19康复供体进行移植结果的知识。
对PubMed和谷歌学术数据库进行文献检索，以识别截至2021年8月10日发表的包含“SARS-CoV2”“COVID-19”“康复供体”和“移植”等关键词的文章。我们确定了25份报告，详细介绍了94例接受腹部和胸部移植的受者，这些供体既有既往感染COVID-19的，也有正在感染的。在既往感染COVID-19的供体报告中，病毒传播给受者以及移植器官功能障碍的发生率较低。终末器官功能障碍和传播在正在感染时更为常见，不过相关报告较少。需要标准化报告，以更好地评估供体症状、循环阈值和个体受者风险因素对术后结果的影响。
现有报告表明，至少在短期随访中，使用COVID-19供体进行移植可能是可行且安全的。然而，需要有标准化的检测和管理方案，应根据可用资源进行调整。虽然COVID-19疫苗接种率的提高将降低供体源性COVID-19的风险并简化管理，但在当前的公共卫生紧急情况期间仍需持续保持警惕。
