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The early outcome of lung transplantation with the lung allografts from the donors tested positive for COVID-19

Presented During:

What's New in Thoracic Transplant?

Saturday, May 6, 2023: 10:00AM - 10:15AM

Los Angeles Convention Center

Posted Room Name: 408A

Abstract No:

Submission Type:

Abstract Submission

Authors:

Takashi Harano (1), Sean Wightman (1), Scott Atay (1), Anthony Kim (1)

Institutions:

(1) Keck Medicine of USC, Los Angeles, CA

Submitting Author:

Takashi Harano - Contact Me
Keck Medicine of USC

Co-Author(s):

Sean Wightman - Contact Me
Keck Medicine of USC

Scott Atay - Contact Me
Keck Medicine of USC

*Anthony Kim - Contact Me
Keck Medicine of USC

Presenting Author:

Takashi Harano - Contact Me
University of Pittsburgh Medical Center

Abstract:

Objective:
COVID-19 can be detected for extended periods of time with nucleic acid test (NAT) even after the virulence and transmissibility become negligible. The lung allograft from the donor who tested positive for COVID-19 has been used for transplantation in highly selected cases. This study aimed to clarify the early outcomes of lung transplantation with COVID-19-positive donors.

Methods: The Organ Procurement and Transplantation Network/United Network for Organ Sharing data between April 2020 and June 2022 was retrospectively analyzed. Multiorgan transplantation was excluded from the analysis.

Results: In the study periods, 29,944 donors were identified, including 1,297 COVID-19-positive donors (4.3%). The lungs were transplanted from 47 donors (3.6%), whereas 296 hearts (22.8%), 733 livers (56.5%), and 1772 kidneys (68.3%) were transplanted. Of these 47 lung donors, COVID-19 was diagnosed with NAT in 22 cases (46.8%). Among the transplanted cases, compared to the lung donors without COVID-19 infection (n=5,433), the COVID-19-positive lung donors are younger (28.4±11.6 years vs. 35.4±13.6 years, p<0.001). On the other hand, the recipients who received the lungs from COVID-19-positive lung allografts (COVID-positive group, n=47) had higher LAS (57.1±23.0 vs. 50.9±20.0, p=0.033) comparing to the recipients who received COVID-19-negative lung allografts (COVID-negative group, n=5,501). The rate of ECMO bridge to lung transplantation (14.9% [7/47] vs. 8.9% [490/5,501], p=0.19) and the waiting time on the waitlist (median 29 days vs. 31 days, p=0.70) were comparable between the two groups. The COVID-positive group are more frequently underwent double lung transplantation (91.5% [43/47] vs 79.5% [4,371/5,501], p=0.044). The post-transplant length of hospital stay (median 16 days vs 19 days, p=0.52), needs of ECMO at 72 hours after transplantation (2.6% [1/38] vs 10.4% [541/5,184], p=0.18), survival outcomes (n = 5,226; logrank test p = 0.48) were comparable between the two group.

Conclusions:
Carefully selected lung allografts from COVID-19-positive donors had comparable early post-transplant outcomes to the lung allografts from COVID-19-negative donors.