Successful liver transplantation from deceased donors with active COVID‐19 infections with undetectable SARS‐CoV‐2 in donor liver and aorta DOI
Sharon R. Weeks,

Ekateria Federova,

Kyungho Lee

et al.

Clinical Transplantation, Journal Year: 2023, Volume and Issue: unknown

Published: July 27, 2023

Background The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has had unprecedented effects on society and modern healthcare. In liver transplantation, uncertainty regarding safety of performing transplants during early stage pandemic resulted in increased waitlist mortality. Additionally, concerns about disease transmission led to avoidance deceased donors with infections. Several successful case reports describing incidental transplant organs from infections or intentional such into recipients current prior prompted community re-evaluate that position. While excellent short-term results have been published, little is known use active extent organ involvement, which may affect long term outcomes. Methods We report transplantation three livers Donor aortic tissues were evaluated sensitive molecular testing for RNA via situ hybridization real-time quantitative reverse transcription PCR. Results Postoperatively, all patients allograft function, without clinical evidence donor tissues. Conclusion This supports

Language: Английский

Liver Transplantation 2023: Status Report, Current and Future Challenges DOI Creative Commons
Norah A. Terrault, Claire Francoz, Marina Berenguer

et al.

Clinical Gastroenterology and Hepatology, Journal Year: 2023, Volume and Issue: 21(8), P. 2150 - 2166

Published: April 20, 2023

Liver transplantation offers live-saving therapy for patients with complications of cirrhosis and stage T2 hepatocellular carcinoma. The demand organs far outstrips the supply, innovations aimed at increasing number usable deceased donors as well alternative donor sources are a major focus. etiologies shifting over time, more need among alcohol-associated liver disease nonalcoholic/metabolic fatty less viral hepatitis, although hepatitis B remains an important indication transplant in countries high endemicity. rise has brought attention to how selected strategies needed prevent recurrent disease. In this review, we present status report on most pressing topics future challenges.

Language: Английский

Citations

125
International Society for Heart and Lung Transplantation Guidelines for the Evaluation and Care of Cardiac Transplant Candidates—2024 DOI
Yael Peled,

Anique Ducharme,

M. Kittleson

et al.

The Journal of Heart and Lung Transplantation, Journal Year: 2024, Volume and Issue: 43(10), P. 1529 - 1628.e54

Published: Aug. 8, 2024

Language: Английский

Citations

21
Transplant of organs from donors with positive SARS‐CoV‐2 nucleic acid testing: A report from the organ procurement and transplantation network ad hoc disease transmission advisory committee DOI
Jason D. Goldman, Stephanie M. Pouch, Ann E. Woolley

et al.

Transplant Infectious Disease, Journal Year: 2023, Volume and Issue: 25(1)

Published: Jan. 24, 2023

Decisions to transplant organs from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid test-positive (NAT+) donors must balance risk of donor-derived transmission events (DDTE) with the scarcity available organs.Organ Procurement and Transplantation Network (OPTN) data were used compare organ utilization recipient outcomes between SARS-CoV-2 NAT+ NAT- donors. was defined by either a positive upper or lower tract (LRT) sample within 21 days procurement. Potential DDTE adjudicated OPTN Disease Transmission Advisory Committee.From May 27, 2021 (date OTPN policy for required LRT testing lung donors) January 31, 2022, recovered 617 all regions 53 57 (93%) procurement organizations. younger had higher quality scores kidney liver. Organ compared A total 1241 (776 kidneys, 316 livers, 106 hearts, 22 lungs, other) transplanted 514 946 8853 Medical urgency recipients liver heart transplants. The median waitlist time longer match run sequence number final acceptor types. Outcomes hospital length stay, 30-day mortality, graft loss similar No occurred in this interval.Transplantation donor appears safe short-term death ameliorates shortage. Further study is assure comparable term outcomes.

Language: Английский

Citations

32
Heart transplantation: advances in expanding the donor pool and xenotransplantation DOI
Stephanie Jou,

Sean R. Mendez,

Jason Feinman

et al.

Nature Reviews Cardiology, Journal Year: 2023, Volume and Issue: 21(1), P. 25 - 36

Published: July 14, 2023

Language: Английский

Citations

25
Beyond donation to organ utilization in the USA DOI
Darren Stewart, Richard Hasz, Bonnie E. Lonze

et al.

Current Opinion in Organ Transplantation, Journal Year: 2023, Volume and Issue: 28(3), P. 197 - 206

Published: March 9, 2023

Purpose of review The deceased donor organ pool has broadened beyond young, otherwise healthy head trauma victims. But an abundance donated organs only benefits patients if they are accepted, expeditiously transported and actually transplanted. This focuses on postdonation challenges opportunities to increase the number transplants through improved utilization. Recent findings We build upon recently proposed changes in terminology for measuring Among recovered transplant, nonuse rate (NUR REC ) risen above 25% kidneys pancreata. donors, DON 40% livers exceeds 70% thoracic organs. Programme-level variation offer acceptance rates vastly traditional, 1-year survival benchmark. Key boost utilization include donation after circulatory death hepatitis C virus (HCV)+ organs; acute kidney injury suboptimal biopsy kidneys; older steatotic livers. Summary Underutilization less-than-ideal, yet transplant-worthy remains obstacle maximizing impact U.S. transplant system. increased risk inferior posttransplant outcomes must always be weighed against risks remaining waitlist. Advanced perfusion technologies; tuning allocation systems placement efficiency; data-driven clinical decision support have potential medically complex

Language: Английский

Citations

16
COVID-19: Has the Liver Been Spared? DOI Open Access
Nicolò Brandi, Daniele Spinelli, Alessandro Granito

et al.

International Journal of Molecular Sciences, Journal Year: 2023, Volume and Issue: 24(2), P. 1091 - 1091

Published: Jan. 6, 2023

The liver is a secondary and often collateral target of COVID-19 disease but can lead to important consequences. might directly cause high number complications in patients with pre-existing chronic disease, increasing their risk hepatic decompensation. Moreover, it also determines indirect consequences the management especially those suffering from decompensated cirrhosis HCC, as well execution follow-up availability all therapeutic possibilities. Liver imaging proved be highly nonspecific, still useful for identifying that derive infection. recent implementation telemedicine constitutes possible solution both physical distancing re-organizational difficulties arising pandemic. present review aims encompass currently hypothesized pathophysiological mechanisms injury mediated by direct invasion virus its effects analyze consequence pandemic tumors, particular regard strategies have been implemented face this worldwide emergency further improved.

Language: Английский

Citations

10
Comparative outcomes for over 100 deceased donor kidney transplants from SARS-CoV-2 positive donors: A single-center experience DOI Creative Commons
Christine Koval, Mohamed Eltemamy,

Emilio D. Poggio

et al.

American Journal of Transplantation, Journal Year: 2022, Volume and Issue: 22(12), P. 2903 - 2911

Published: Sept. 30, 2022

Emerging data support the safety of transplantation extra-pulmonary organs from donors with SARS-CoV-2-detection. Our center offered kidney (KT) deceased (DD) SARS-CoV-2 and without COVID-19 as a cause death (CoV + COD CoV+) to consenting candidates. No pre-emptive antiviral therapies were given. We retrospectively compared outcomes contemporaneous DDKTs negative testing (CoVneg). From February 1, 2021 January 31, 2022, there 220 adult KTs, including 115 (52%) 35 CoV+ 33 CoV donors. Compared CoVneg CoV+, more often DCD (100% vs. 40% 46%, p < .01) longer cold ischemia times (25.2 h 22.9 22.2 h, = .02). At median follow-up 5.7 months, recipients kidneys had similar rates delayed graft function (10.3%, 21.8% 21.9%, .16), rejection (5.1%, 0% 8.5%, .07), failure (1.7%, 0%, .35), mortality (0.9%, 3.7%; .29), diagnoses (13.6%, 7.1%, 15.2%, .33). Though was shorter, associated lower but acceptable eGFR on multivariable analysis. KT DDs at various stages infection appears safe successful. Extended is required assess impact term function.

Language: Английский

Citations

13
Patterns in Use and Transplant Outcomes Among Adult Recipients of Kidneys From Deceased Donors With COVID-19 DOI Creative Commons
Mengmeng Ji, Amanda J. Vinson, Su‐Hsin Chang

et al.

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(5), P. e2315908 - e2315908

Published: May 30, 2023

Importance While the COVID-19 pandemic enters a new phase and proportion of individuals with previous diagnosis increases, national patterns in kidney use medium-term transplant (KT) outcomes among patients receiving kidneys from active or resolved COVID-19–positive donors remain unknown. Objective To evaluate KT adult recipients deceased COVID-19. Design, Setting, Participants This retrospective cohort study was conducted using US registry data 35 851 (71 334 kidneys) 45 912 who received KTs March 1, 2020, to 30, 2023. Exposure The exposure donor SARS-CoV-2 nucleic acid amplification test (NAT) results, positive NAT results within 7 days before procurement defined as 1 week (&amp;gt;7 days) Main Outcomes Measures Primary were nonuse, all-cause graft failure, patient death. Secondary acute rejection (ie, first 6 months after KT), hospitalization length stay (LOS), delayed function (DGF). Multivariable logistic regression analyses performed for rejection, DGF; multivariable linear LOS; Cox failure All models adjusted inverse probability treatment weighting. Results Among donors, mean (SD) age 42.5 (15.3) years; 22 319 (62.3%) men 23 992 (66.9%) White. recipients, 54.3 (13.2) 27 952 (60.9%) 15 349 (33.4%) Black. likelihood nonuse decreased over time. Overall, (adjusted odds ratio [AOR], 1.55; 95% CI, 1.38-1.76) (AOR, 1.31; 1.16-1.48) had higher compared COVID-19–negative donors. From 2020 2022, (2020: AOR, 11.26 [95% 2.29-55.38]; 2021: 2.09 1.58-2.79]; 2022: 1.47 1.28-1.70]) without Kidneys 3.87; 1.26-11.90) 2021 1.94; 1.54-2.45) but not 2022 1.09; 0.94-1.28). In 2023, both 1.07; 0.75-1.63) 1.18; 0.80-1.73) associated nonuse. No risk death found (graft failure: hazard [AHR], 1.03 0.78-1.37]; death: AHR, 1.17 0.84-1.66]) 1.10 0.88-1.39]; 0.95 0.70-1.28]). Donor positivity longer LOS, DGF. Conclusions Relevance this study, time, worse 2 years transplant. These findings suggest that is safe medium term; further research needed assess longer-term outcomes.

Language: Английский

Citations

7
Is Transplantation With Coronavirus Disease 2019–Positive Donor Lungs Safe? A US Nationwide Analysis DOI
Richa Asija, Ruby Singh, Dane C. Paneitz

et al.

The Annals of Thoracic Surgery, Journal Year: 2023, Volume and Issue: 116(5), P. 1046 - 1054

Published: July 27, 2023

Language: Английский

Citations

6
Comparison of Short-Term Outcomes in Kidney Transplant Recipients from SARS-CoV-2–Infected versus Noninfected Deceased Donors DOI Open Access
Junji Yamauchi, Ambreen Azhar, Isaac E. Hall

et al.

Clinical Journal of the American Society of Nephrology, Journal Year: 2023, Volume and Issue: 18(11), P. 1466 - 1475

Published: Aug. 14, 2023

Acceptable post-transplant outcomes were reported in kidney transplant recipients from donors with coronavirus disease 2019 (COVID-19); however, there are no comparative studies well-matched controls.

Language: Английский

Citations

6