Table 3.
Summary of recommendations from various organizations regarding abdominal organ transplant donors, candidates and recipients.
| Population | Subject | Current recommendations | Endorsed by |
|---|---|---|---|
| Deceased donors | COVID-19 testing | Routine testing of donors only in areas with significant ongoing community transmission | TTS |
| Routine testing of donors with epidemiological or clinical risk factors | AST | ||
| Routine testing of all donors | ASTS | ||
| Testing method | Both upper (nasopharyngeal/oropharyngeal swab) and lower airway samples (BAL) | AST, TTS | |
| Lower airway sample (BAL) | ASTS | ||
| Exclusion from donation | COVID-19 patients | AST, ASTS | |
| High-risk patients according to travel or contact history | AST, TTS | ||
| High-risk patients according to clinical symptoms | AST | ||
| Intermediate risk patients according to travel/contact history or clinical symptoms and unavailable COVID-19 testing (only if intestines are used) | AST | ||
| Donation suspension | Tiered suspension should only be considered in countries with widespread transmission | TTS | |
| May need to be considered for non-urgent cases | AST | ||
| Should be considered on a case-by-case basis | ASTS | ||
| Living donors | COVID-19 testing | Routine testing of donors with epidemiological or clinical risk factors | AST |
| Routine testing of donors if available | TTS | ||
| Routine testing of all donors | ASTS | ||
| Testing method | Both upper (nasopharyngeal/oropharyngeal swab) and lower airway samples (BAL) | TTS | |
| Upper (nasopharyngeal/oropharyngeal swab) | AST, ASTS | ||
| Exclusion from donation | Any person with respiratory symptoms or fevera | AST, ASTS, TTS | |
| Any person with high-risk travel or contact historya, b | AST, TTS | ||
| COVID-19 patients | AST, ASTS | ||
| Donation suspension | Should be considered for non-urgent cases | AST, ASTS, TTS | |
| Candidates | Consultations | Telemedicine or phone consultations should be utilized whenever possible | AST, ASTS |
| COVID-19 testing | If the patient is considered high-risk for COVID-19 exposure and testing is available | AST | |
| Transplantation deferment | For COVID-19 patients until ≥ 2 negative samples and symptom resolution | AST | |
| Temporary suspension of all non-urgent cases may be considered | AST, ASTS, TTS | ||
| Recipients | Travel | Avoid all travel in areas with SARS-CoV-2 transmission | TTS |
| Avoid cruise ships | TTS | ||
| Avoid all non-essential travel | AST | ||
| Medication | Patients should carry an extended supply of their medicines | AST, ASTS | |
| Symptom development | Patients should call their transplant centers and avoid going to clinics | AST, ASTS, TTS |
BAL, Bronchoalveolar lavage; TTS, The Transplantation Society; AST, American Society of Transplantation, ASTS, American Society of Transplant Surgeons.
a
The AST recommends deferment for 28 days beyond symptom resolution plus ≥ 2 negative SARS-CoV-2 tests if high-risk.
b
TTS recommends deferment for 14 days.