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Heart Transplant Survival Affected With COVID-19-Positive Donor Organs

In HealthDay News
by Healthday

Increased mortality seen at six months and one year for heart transplant from donors with active COVID-19

By Elana Gotkine HealthDay Reporter

THURSDAY, May 18, 2023 (HealthDay News) — Heart transplant (HT) recipients from donors with active COVID-19 have increased mortality at six months and one year, while survival is similar for recently resolved COVID-19 donors and non-COVID-19 donors, according to a study published online May 17 in the Journal of the American College of Cardiology.

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Shivank Madan, M.D., from Montefiore Medical Center and Albert Einstein College of Medicine in Bronx, New York, and colleagues examined data for HT using COVID-19 donors. A total of 27,892 donors were identified between May 2020 and June 2022 with 60,699 COVID-19 nucleic acid amplification tests (NAT). Donors were considered COVID-19 donors if they were NAT-positive at any time during hospitalization and were further classified as active-COVID-19 (aCOV) if NAT-positive within two days of organ procurement and recently resolved COVID-19 (rrCOV) if initially NAT-positive but became NAT-negative before procurement. A total of 1,445 COVID-19 NAT-positive donors were identified: 1,017 aCOV and 428 rrCOV. Overall, 239 adult-HT recipients from COVID-19 donors met the inclusion criteria (150 aCOV; 89 rrCOV).

COVID-19 donors were younger and mostly male compared with non-COVID-19 donors. The researchers found that HTs from aCOV donors had increased mortality at six months and one year compared with HTs from non-COVID-19 donors (hazard ratios, 1.74 and 1.98, respectively). Similar six-month and one-year mortality was seen for rrCOV and non-COVID-19 donors. In propensity-matched cohorts, the results were similar.

“These early trends should be concerning enough such that heart transplantation centers need to thoroughly evaluate and continue to weigh the risks/benefits of using hearts from active COVID-19 donors,” Madan said in a statement.

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