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