DETROIT – With careful screening, organ transplants are still carried out in the era of COVID-19.
However, doctors are learning more about how the disease can escape detection on a daily basis.
A Michigan woman tragically died of COVID-19 from the transplanted lungs that were supposed to save her life.
Lung transplants are still being done. In fact, a lung transplant can save the life of someone whose lungs have been destroyed by COVID-19.
In cases not related to COVID-19, both the donor and recipient are routinely screened to ensure that they are free of infection, but a new case highlights a need for more advanced screening. Last year, nearly 40,000 organs were transplanted in the U.S. with over 2,500 being lung transplants roughly the same number that had been done in past years.
Now a new report from the University of Michigan published in the American Journal of Transplantation describes the first case of COVID-19 that was transmitted in a pair of lungs.
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The donor was a woman who suffered a severe brain injury in a car accident. She had no history of COVID-19 or any symptoms like fever, cough, or headache and prior to organ procurement, she had a nasal swab that was negative for the COVID-19 virus.
The woman who received the donated lungs had end stage Chronic obstructive pulmonary disease (COPD) and was also negative for the COVID-19 virus.
Three days after her lung transplant, she developed fevers and worsening lung function. A CAT scan of her new lungs looked like COVID.
Even though the donor’s nasal swab had been negative for COVID, they were found to be positive when they went back and tested her original lung washings.
During the initial procedure, doctors believed both the donor and recipient were free of COVID and therefore weren’t required to wear an N-95 mask or eye protection.
The thoracic surgeon who performed the transplant tested positive four days after the surgery. Sixty one days after the transplant, the recipient died.
In studying what happened, the viruses from the donor, the recipient and the surgeon all underwent genetic sequencing.
The coronavirus in both the donor and recipient were identical. Additonally, the virus from the surgeon was essentially identical only different by one mutation thought to have occurred during his infection.
It’s not really clear if the virus can be spread by other organ transplants, but COVID screening of donors has been done since the start of the pandemic and specifically for non-lung donors they recommend at least one sample from the respiratory tract.