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

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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.

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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