Figure 4. Algorithm of the SARS-CoV-2 Test Strategy for the brain death donor and candidate for heart transplantation during COVID-19 outbreak. Brain death donors should be tested for SARS-CoV-2 infection (preferably rRT-PCR assay from upper and/or lower respiratory tract specimens). If the test result is negative, organ donation can be safely proceeded. When the heart transplantation recipient has symptoms suggesting viral infection, unknown cause of fever, or close contact history with the SARS-CoV-2 infected patients prior 14 days, test for SARS-CoV-2 infection should be performed and proceed heart transplantation when the result is negative. Members of the donor management team and the organ procurement team should apply adequate personal protective equipment. Confirmation of the negative SARS-CoV-2 result need to be ensured according to the strategy of each hospital organ procurement organization. If the symptom of SARS-CoV-2 infection is highly suggested, repeated test need to be performed for the suspicious result.

SARS-CoV-2 = severe acute respiratory syndrome coronavirus-2; COVID-19 = coronavirus disease 2019; rRT-PCR = real-time reverse transcription polymerase chain reaction; PPE = personal protective equipment.