Kidneys donated from deceased patients who tested positive for COVID-19 are safe to transplant and don’t pass the infection on to recipients, according to a study from researchers at Washington University.
The findings could encourage more confidence among transplant providers and patients, said Dr. Tarek Alhamad, a transplant nephrologist at Wash U and one of the study’s authors. During the coronavirus pandemic, kidney donations decreased as doctors worried that the organs would put recipients’ health at risk, he said.
“These outcomes are excellent,” Alhamad said. “There was no case of COVID-19 transmission from kidney transplantations, so hopefully more providers and more patients accept these organs.”
For the study published in JAMA Network Open late last month, doctors studied three years of transplant data from more than 45,000 recipients starting in March 2020. They found no higher risk of failure, organ rejection or death in patients receiving kidneys from donors who had COVID-19 than in patients who received kidneys from those who tested negative for the virus.
Kidney recipients whose donor had tested positive for the virus also did not have longer hospital stays or acute kidney injuries, the study found.
The number of organ donations, and especially kidney donations, decreased significantly during the pandemic, said Dr. Harry Randall, director of the abdominal transplant program at SSM Health St. Louis University Hospital.
“We were fighting this uphill battle, trying to learn as much as we could about the disease itself: how to treat it and what the impact of the disease was on the donor population and also on the recipient populations,” he said. “Most of us sort of went — not into a deep hibernation, but a light sleep — until we got a little more information.”
If a kidney is unhealthy or damaged from illness — including COVID-19 — doctors do not use it for a transplant.
Hospital workers rigorously test donors for infectious diseases and other problems before transplanting an organ, Randall said. After months of studying the coronavirus, doctors figured out a way to test whether an organ was safe to transplant by calculating how rapidly a virus is replicating inside a donor’s blood. People who replicated a virus above a certain threshold were deemed unable to donate their organs.
Randall said SSM Health and many other hospitals have adopted that strategy.
“COVID isn’t over, but we’re in a state where things are back to near normal in some cases,” he said. “Don’t be afraid to donate! Don’t be afraid to be a recipient. We are going to test for everything.”
Alhamad said providers are discarding fewer kidneys as the pandemic wanes. He hopes the findings will further encourage people to donate the valuable organs.
“There are around 100,000 patients waiting for organ transplants. That waiting time can be quite long. It ranges from three to five years,” he said. “These organs are quite valuable, and patients are waiting for years on dialysis to get a kidney transplant.”
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