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SARS-CoV-2 下呼吸道 NAT 阳性供体的短期肝移植结局。

Short-term liver transplant outcomes from SARS-CoV-2 lower respiratory tract NAT positive donors.

机构信息

Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

出版信息

Transpl Infect Dis. 2022 Feb;24(1):e13757. doi: 10.1111/tid.13757. Epub 2021 Dec 14.


DOI:10.1111/tid.13757
PMID:34741572
Abstract

On April 2021, the United States Organ Procurement and Transplantation Executive Committee approved the "lower respiratory SARS-CoV-2 testing for lung donors" emergency policy upon recommendation from the Ad Hoc Disease Transmission Advisory Committee. This policy requires that all lung donors be tested for SARS-CoV-2 in a lower respiratory specimen by nucleic acid test (NAT) and that the results be available before the lungs are transplanted. The overarching goal of the emergency policy was to minimize the risk of donor-derived COVID-19 to lung recipients. However, an unintended consequence of the policy was the emergence of a new population of potential donors: the SARS-CoV-2 lower respiratory tract (LRT) NAT positive donor. We describe the use of two SARS-CoV-2 LRT NAT positive liver donors without a known history of COVID-19 infection with adequate short-term outcomes. The recipients did not have a prior history of COVID-19, nor did they receive monoclonal antibodies post-transplantation; one was unvaccinated. If the safety and long-term outcomes from SARS-CoV-2 LRT NAT positive donors are confirmed in larger studies, this strategy represents a promising way to increase the pool for organ donation.

摘要

2021 年 4 月,应特别疾病传播咨询委员会的建议,美国器官获取和移植执行委员会批准了“用于肺供体的下呼吸道 SARS-CoV-2 检测”的紧急政策。该政策要求所有肺供体均通过核酸检测(NAT)在下呼吸道标本中检测 SARS-CoV-2,并在移植肺之前获得检测结果。该紧急政策的总体目标是尽量降低供体源性 COVID-19 对肺受者的风险。然而,该政策的一个意外后果是出现了新的潜在供体人群:SARS-CoV-2 下呼吸道(LRT)NAT 阳性供体。我们描述了两名 SARS-CoV-2 LRT NAT 阳性的肝供体的使用情况,这些供体没有已知的 COVID-19 感染史,且短期结果良好。受者没有 COVID-19 的既往病史,也没有在移植后接受单克隆抗体治疗;其中一名受者未接种疫苗。如果在更大规模的研究中证实 SARS-CoV-2 LRT NAT 阳性供体的安全性和长期结果,那么这一策略代表了增加器官捐献来源的一种有前景的方法。

相似文献

[1]
Short-term liver transplant outcomes from SARS-CoV-2 lower respiratory tract NAT positive donors.

Transpl Infect Dis. 2022-2

[2]
Transplant of organs from donors with positive SARS-CoV-2 nucleic acid testing: A report from the organ procurement and transplantation network ad hoc disease transmission advisory committee.

Transpl Infect Dis. 2023-2

[3]
Short-term kidney transplant outcomes from severe acute respiratory syndrome coronavirus 2 lower respiratory tract positive donors.

Transpl Infect Dis. 2022-8

[4]
A new chapter in an evolving pandemic: Successful pediatric liver transplantation with SARS-CoV-2+ donors.

Pediatr Transplant. 2022-12

[5]
Utilization and outcomes of deceased donor SARS-CoV-2-positive organs for solid organ transplantation in the United States.

Am J Transplant. 2022-9

[6]
Liver transplantation from active COVID-19 donors: A lifesaving opportunity worth grasping?

Am J Transplant. 2021-12

[7]
Risk of Severe Acute Respiratory Syndrome Coronavirus 2 Transmission Through Solid Organ Transplantation and Outcomes of Coronavirus Disease 2019 Among Recent Transplant Recipients.

Open Forum Infect Dis. 2022-5-2

[8]
Expedited SARS-CoV-2 screening of donors and recipients supports continued solid organ transplantation.

Am J Transplant. 2020-6-23

[9]
Solid organ transplantation from donors with recent or current SARS-CoV-2 infection: A systematic review.

Anaesth Crit Care Pain Med. 2022-8

[10]
Donor to recipient transmission of SARS-CoV-2 by lung transplantation despite negative donor upper respiratory tract testing.

Am J Transplant. 2021-8

引用本文的文献

[1]
Update on Covid-19: vaccines, timing of transplant after COVID-19 infection and use of positive donors.

Curr Opin Organ Transplant. 2023-4-1

[2]
The impact of COVID-19 on kidney transplant care.

Front Med (Lausanne). 2023-1-9

[3]
A new chapter in an evolving pandemic: Successful pediatric liver transplantation with SARS-CoV-2+ donors.

Pediatr Transplant. 2022-12

[4]
SARS-CoV-2 NAT+ donors for pediatric solid organ transplant recipients-Are they safe and provide good outcomes?

Pediatr Transplant. 2022-12

[5]
Comparative outcomes for over 100 deceased donor kidney transplants from SARS-CoV-2 positive donors: A single-center experience.

Am J Transplant. 2022-12

[6]
COVID-19 positive donor for solid organ transplantation.

J Hepatol. 2022-10

[7]
Low risk high reward: What should we worry about with coronavirus disease 2019 positive donors?

Transpl Infect Dis. 2022-8

[8]
Short-term kidney transplant outcomes from severe acute respiratory syndrome coronavirus 2 lower respiratory tract positive donors.

Transpl Infect Dis. 2022-8

[9]
Utilization and outcomes of deceased donor SARS-CoV-2-positive organs for solid organ transplantation in the United States.

Am J Transplant. 2022-9

[10]
Solid organ transplantation from donors with recent or current SARS-CoV-2 infection: A systematic review.

Anaesth Crit Care Pain Med. 2022-8

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