Safety of Kidneys from COVID-19-Positive Donors for Transplant

Core Concepts

Kidneys from COVID-19-positive donors are safe for transplant, with no increased risk of rejection or failure.

Abstract

The content discusses the safety of using kidneys from donors with resolved or active COVID-19 for transplantation. It presents findings from a retrospective cohort study involving deceased donors, kidney recipients, and patient outcomes over a two-year period. The study indicates a decreasing reluctance to use kidneys from COVID-19-positive donors and emphasizes the lack of increased risk associated with these organs.

Key Highlights:

• Patients receiving kidneys from COVID-19-positive donors show no greater risk of poor outcomes or death.
• The study found a decline in the nonuse of kidneys from COVID-19-positive donors over time.
• Kidneys from donors with resolved or active COVID-19 did not have an increased risk of rejection or failure.
• Outcomes associated with kidneys from COVID-19-positive donors were comparable to those from COVID-19-negative donors.
• The study supports the safety of using organs from donors with resolved or active COVID-19 for transplantation.

Stats

"Among the donors, the mean age was 42.5 years, 62.3% were male and 66.9% were White, and among the recipients, the mean age was 54.3, 60.9% were male and 33.4% were Black."
"Overall, kidneys from donors with active COVID-19 had a significantly higher likelihood of not being used vs kidneys from COVID-19–negative donors (adjusted odds ratio [AOR], 1.55)."
"The rate of nonuse from active COVID-19 donors declined significantly by 2021 (AOR, 2.09), and dropped further by 2022 (AOR, 1.47)."

Quotes

"Our study shows no increased risk of rejection and no increased risk of kidney failure with the use of kidneys from COVID-19–positive donors." - Alhamad
"Transplant of kidneys from donors with resolved or active COVID-19 was not associated with increased risk of all-cause graft loss, all-cause death, acute rejection, delayed graft function, or longer hospitalization over more than 2 years of follow-up compared with kidneys from COVID-19–negative donors." - Authors

Key Insights Distilled From

Kidneys From COVID-19-Positive Donors Safe for Transplant

by Nancy A. Mel... at www.medscape.com 05-30-2023

https://www.medscape.com/viewarticle/992543

Deeper Inquiries

How can the findings of this study impact the current practices of kidney transplantation?

The findings of this study can significantly impact current practices of kidney transplantation by providing evidence that kidneys from COVID-19-positive donors, both with resolved and active infections, are safe for transplant. This research indicates that there is no increased risk of rejection, kidney failure, or poor outcomes for recipients of kidneys from such donors. As a result, transplant centers may become more willing to utilize kidneys from COVID-19-positive donors, reducing the discard rate of these valuable organs. This shift in practice could potentially increase the pool of available organs for transplantation, addressing the ongoing organ shortage crisis.

What ethical considerations should be taken into account when using organs from COVID-19-positive donors?

When using organs from COVID-19-positive donors, several ethical considerations must be taken into account. Firstly, informed consent becomes crucial, as recipients should be fully informed of the donor's COVID-19 status and the associated risks, even though the study shows no increased risk of adverse outcomes. Transparency in communication is essential to ensure that recipients can make well-informed decisions. Additionally, equity in access to transplantation is vital, ensuring that all patients have fair opportunities to receive organs regardless of the donor's COVID-19 status. Furthermore, there should be ongoing monitoring and research to assess the long-term effects of receiving organs from COVID-19-positive donors to ensure the safety and well-being of transplant recipients.

How might the acceptance of kidneys from COVID-19-positive donors influence the organ donation landscape in the future?

The acceptance of kidneys from COVID-19-positive donors could have a transformative impact on the organ donation landscape in the future. By demonstrating the safety and efficacy of using organs from such donors, this study may lead to a paradigm shift in how organs are evaluated for transplantation. It could potentially reduce the stigma associated with organs from COVID-19-positive donors and increase the utilization of these organs, thereby expanding the pool of available organs for transplantation. This shift may also encourage further research into the transplantation of organs from donors with infectious diseases, paving the way for more innovative and inclusive practices in organ donation and transplantation.