Still unknown how COVID-19 will impact organ transplants

April 9, 2023

Healthcare organizations around the world are mobilizing to respond to COVID-19 and the impact to transplant recipients—like so much else about the virus—is far from clear. Initial findings from the University of Washington suggest that transplant recipients infected with COVID-19 are not at risk due to low-dose immunosuppression drugs, but rather due to existing comorbidities. Supportive care without changes to immunosuppression drugs were provided for these patients. The data was described as preliminary by Dr. Ajit P. Limaye, Director of the University of Washington Medical Center's Transplant Infectious Disease Program, with only a 5-person sample size. All transplant recipients had been on low-dose immunosuppression drugs and had received transplants at least 10 years prior.

The University of Washington Medical Center has chosen to continue to transplant organs to patients, but Dr. Limaye described many unknowns in a COVID 19 Organ Donation and Transplant Town Hall organized by the American Society for Transplantation. Dr. Limaye noted it is reasonable to suspect that organ transplant recipients might be at increased risk for acquiring the virus. Immunosuppression drugs are a factor, but behaviour acquisition through increased contact with health care workers and the health care system are also possibilities.

Data from Wuhan indicates that the risk for donor-derived transmission is greater for lung and GI transplants. To date, there are no recorded transmissions of RNA respiratory viruses to non-lung recipients, despite a high prevalence of these viruses. Dr. Limaye noted many centers already transplant organs with increased risk or HCV using informed consent, but that informed consent becomes more challenging due to the continued unknowns around COVID-19. Decisions around organ transplants can be focused on selected benefits to maximize benefit. For some patients, waiting may be worse than COVID-19 exposure.

The University of Washington Medical Center is testing all patients for COVID-19, has suspended all non-urgent elective surgeries, and is offering telehealth appointments at more clinics. Where feasible, waitlisted transplant patients and recipients are advised to avoid non-essential visits or use telehealth options.

Learn more about how Afflo facilitates telemedicine and the rapid update and testing of allocation algorithms to help transplant programs respond to COVID-19.

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