Organ transplant is a possible hematogenous and infectious disease transmission process. Is COVID-19 infected patients possible for organ donation after death? E.g. the cornea.
Dear Dr.Sunny,
There are several diseases that are transmitted through organ transplantation.I have mentioned such diseases in my book entitled ' Zoonoses"
It is therefore, advisable not to transplant the organ from the patient suffering from infectious diseases including CoronD-19).
With kind regards,
Prof.Dr.Mahendra Pal
Founder Director of Narayan Consultancy on Veterinary Public Health
It is my pleasure to know your book, professor.
Do you have any access link for that?
Corneal transplant is a bit different from other visceral organ transplant in terms that donor cornea will be screened under microscopy for any abnormalities as quality check
Despite the small size of the virus, will the corneal donor graft screening with confocal scanning laser microscope be able to detect virus?
What if the organ to be transplanted is vital without which the patient's prognosis is poor? e.g. liver transplant for fulminant hepatic failure from a COVID-19 positive donor. I believe there is some talk about transplant patients not showing the stormy inflammatory reaction triggered by COVID-19 and facilitated by interleukins. Thus, less severe presentation of COVID-19 in these patients.
This will definitely be a hot research topic in transplant medicine
This will definitely be a hot research topic in transplant medicine
I believe the donation should be avoided. It is import to weight risks and benefits. But, as we are dealing with a high risk population, it should be avoided, searching for alternative options while a healthy organ doesn't come.
Additionally, read these before making any assumptions
1. Aslam S, Mehra MR. COVID-19: Yet Another Coronavirus Challenge in Transplantation. The Journal of Heart and Lung Transplantation 2020
2. D'Antiga L. Coronaviruses and immunosuppressed patients. The facts during the third epidemic.
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society 2020
3. Guillen E, Pineiro GJ, Revuelta I, et al. Case report of COVID-19 in a kidney transplant recipient: Does immunosuppression alter the clinical presentation? American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons 2020
4. Lu X, Ming C, Wen Z, et al. Clinical analysis of 2019 coronavirus disease (COVID-19) on one case with living-related kidney transplantation. Chinese Journal of Organ Transplantation 2020;41(0):E006-E06.
5. Pan L, Zeng J, Yang H. Challenges and countermeasures for organ donation during the SARS- CoV-2 epidemic: the experience of Sichuan Provincial People’s Hospital. Intensive Care Medicine 2020
6. Qiu T, Wang J, Zhou J, et al. The report of two cases infection with novel coronavirus (2019-ncov) after kidney transplantation and the association literature analyzation. Chinese Journal of Organ Transplantation 2020;41(0):E004-E04.
Effectiveness of convalescent plasma therapy in severe COVID-19 patients Kai Duan, et al Proceedings of the National Academy of Sciences Apr 2020, 202004168;
DOI: 10.1073/pnas.2004168117
At the present time, we do not have enough data on the viability of the virus in different tissues and organs even after the death of an infected patient. Hence, as far as I am aware, transplantation from a COVID-19 positive patient after death is not recommended at this time
What do you think about this mechanism/
Endothelial cell infection and endotheliitis in COVID-19
https://doi.org/10.1016/S0140-6736(20)30937-5
Covid-19 and Kidney Transplantation. N Engl J Med. 2020 Apr 24.
https://doi.org/10.1056/NEJMc2011117
In Brazil, all deceased donors are tested for SARS-CoV-2 by PCR before donation. Those whose PCR is positive are automatically discarded.
Although that organ transplantation from a COVID-19 patient is not recommended at this time due to insufficient background researches, this study shows that there is a much higher fatality risk in the population of patients older than 60 years that has COVID-19 infection and also undergone abdominal SOT.
(Nacif, L.S. 2020)
https://doi.org/10.6061/clinics/2020/e1983
A recent study analyzed the prevalence of SARS-CoV-2 in human post-mortem ocular tissues. The data suggests that some eyes from covid-19 positive donors are theoretically eligible for corneal transplantation: DOI, 10.1101/2020.10.05.20201574