Single-center Outcomes After Liver Transplantation With SARS-CoV-2–Positive Donors: An Argument for Increased Utilization
| Title: | Single-center Outcomes After Liver Transplantation With SARS-CoV-2–Positive Donors: An Argument for Increased Utilization |
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| Authors: | Ashton A. Connor, MD, PhD, Max W. Adelman, MD, Constance M. Mobley, MD, PhD, Mozhgon Moaddab, PharmD, Alexandra J. Erhardt, MD, David E. Hsu, MSc, Elizabeth W. Brombosz, PhD, Mansi Sanghvi, MD, Yee Lee Cheah, MD, Caroline J. Simon, MD, Mark J. Hobeika, MD, Ashish S. Saharia, MD, David W. Victor, III, MD, Sudha Kodali, MD, Tamneet Basra, MD, Edward A. Graviss, PhD, Duc T. Nguyen, MD, PhD, Ahmed Elsaiey, MD, Linda W. Moore, PhD, Masayuki Nigo, MD, Ashley L. Drews, MD, Kevin A. Grimes, MD, Cesar A. Arias, MD, PhD, Xian C. Li, MD, PhD, A. Osama Gaber, MD, R. Mark Ghobrial, MD, PhD |
| Source: | Transplantation Direct, Vol 10, Iss 4, p e1590 (2024) |
| Publisher Information: | Wolters Kluwer, 2024. |
| Publication Year: | 2024 |
| Collection: | LCC:Surgery |
| Subject Terms: | Surgery, RD1-811 |
| More Details: | Background. The COVID-19 pandemic has led to an increase in SARS-CoV-2–test positive potential organ donors. The benefits of life-saving liver transplantation (LT) must be balanced against the potential risk of donor-derived viral transmission. Although emerging evidence suggests that the use of COVID-19–positive donor organs may be safe, granular series thoroughly evaluating safety are still needed. Results of 29 consecutive LTs from COVID-19–positive donors at a single center are presented here. Methods. A retrospective cohort study of LT recipients between April 2020 and December 2022 was conducted. Differences between recipients of COVID-19–positive (n = 29 total; 25 index, 4 redo) and COVID-19–negative (n = 472 total; 454 index, 18 redo) deceased donor liver grafts were compared. Results. COVID-19–positive donors were significantly younger (P = 0.04) and had lower kidney donor profile indices (P = 0.04) than COVID-19–negative donors. Recipients of COVID-19–positive donor grafts were older (P = 0.04) but otherwise similar to recipients of negative donors. Donor SARS-CoV-2 infection status was not associated with a overall survival of recipients (hazard ratio, 1.11; 95% confidence interval, 0.24-5.04; P = 0.89). There were 3 deaths among recipients of liver grafts from COVID-19–positive donors. No death seemed virally mediated because there was no qualitative association with peri-LT antispike antibody titers, post-LT prophylaxis, or SARS-CoV-2 variants. Conclusions. The utilization of liver grafts from COVID-19–positive donors was not associated with a decreased overall survival of recipients. There was no suggestion of viral transmission from donor to recipient. The results from this large single-center study suggest that COVID-19–positive donors may be used safely to expand the deceased donor pool. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 2373-8731 00000000 |
| Relation: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001590; https://doaj.org/toc/2373-8731 |
| DOI: | 10.1097/TXD.0000000000001590 |
| Access URL: | https://doaj.org/article/52873567970f4b91b1a294efdb791378 |
| Accession Number: | edsdoj.52873567970f4b91b1a294efdb791378 |
| Database: | Directory of Open Access Journals |
| ISSN: | 23738731 00000000 |
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| DOI: | 10.1097/TXD.0000000000001590 |
| Published in: | Transplantation Direct |
| Language: | English |