TABLE 5.
Transplant outcomes utilizing the transplant donor and transplant candidate COVID-19 screening and assessment protocol
| Decision | Exposure category | Clinical risk category | Risk category | Comment | ||
|---|---|---|---|---|---|---|
| Heart | ||||||
| 7 primary offers | Transplanted | Donor | 0 | 0 | Low | Of note, 1 candidate received a heart/lung, and 1 candidate received a heart/kidney |
| Candidate | ✓ | ✓ | ||||
| 1 primary offer | Not transplanted | Donor | 0 | 3 | High | Donor was found to have an indeterminate SARS-CoV-2 RT-PCR |
| Candidate | ✓ | ✓ | ||||
| 2 primary offers | Not transplanted | Donor | 0 | 0 | Low | One transplant candidate was found to have a positive telephone screen (malaise and cough). The other transplant candidate had profound dyspnea on exam and a CT Chest suggestive of COVID-19. Both candidates tested negative for SARS-CoV-2 |
| Candidate | ✗ | ✗ | ||||
| Lung | ||||||
| 3 primary offers | Transplanted | Donor | 0 | 0 | Low | |
| Candidate | ✓ | ✓ | ||||
| Kidney | ||||||
| 2 primary offers | Transplanted | Donor | 0 | 0 | Low | |
| Candidate | ✓ | ✓ | ||||
| Liver | ||||||
| 15 primary offers | Transplanted | Donor | 0 | 0-1 | Low | One donor was febrile, but clinical risk score was low and therefore transplant proceeded |
| Candidate | ✓ | ✓ | ||||
| 1 primary offer | Not transplanted | Donor | 3 | 1 | Moderate | Donor had symptoms of respiratory distress and known exposure to COVID-19 positive people |
| Candidate | ✓ | ✓ | ||||
| 1 primary offer | Not transplanted | Donor | 0 | 0 | Low | Candidate was found to have CT Chest imaging with ground glass opacities concerning for infectious etiology. Transplant was deferred per protocol, and repeated RT-PCRs were negative. The candidate later proceeded to transplant with a different donor organ. |
| Candidate | ✓ | ✗ | ||||
Note: Ten primary heart offers were considered of which 7 were transplanted. Three lung and 2 kidney primary offers were considered, of which all were transplanted. Seventeen primary liver offers were considered of which 15 were transplanted. All of these donors and candidates had met prespecified criteria to proceed with transplant, and thus only those utilizing the algorithm during the study time are reported. At the time of this submission, there are no recipients in this cohort who have tested positive for SARS-CoV-2 since transplantation.
✓, candidate met criteria to proceed with transplant, no evidence of COVID-19 infection; ✗, candidate had clinical symptoms and/or signs of COVID-19 infection, transplant deferred—see comments