In what doctors believe to be the first case of its kind since the start of the pandemic, a Michigan lung transplant recipient has died after it was discovered that the donor’s lungs were infected with COVID-19, despite having been tested before the procedure.
The double-lung procedure, which took place at University Hospital in Ann Arbor last fall, resulted in the death of the chronic obstructive lung disease patient a mere 61 days later. Just three days after the transplant, the patient developed difficulty breathing, as well as high fever, low blood pressure. The infection, which was found to originate in the lungs, led to septic shock, heart issues, and, eventually death, NBC News reports.
Those health care workers who cared for the recipient were not required to wear protective gear, such as N95 masks nor eye protection, because both the donor and recipient had tested negative prior to the procedure, WXYZ reports. The surgeon who handled the donor’s lungs also tested positive for the virus four days after the transplant, though later recovered.
“We would absolutely not have used the lungs if we’d had a positive COVID test,” Dr. Daniel Kaul, who co-authored a report about the case in the American Journal of Transplantation, told NBC News. “All the screening that we normally do and are able to do, we did.”
The donor was a woman who following a car accident in November suffered a severe brain injury that ultimately advanced to “brain death.” Her lungs were tested prior to the donation and tested negative, and she was said to not have exhibited any COVID-19 symptoms prior to her death, nor did she travel.
As the recipient’s condition continued to worsen, doctors decided to test lung tissue from the new lungs for COVID-19. When they did, the tests came back positive.
So, why did the initial testing, which occurred 48 hours after the lungs had been obtained by the hospital, come back negative? Well, according to doctors, they didn’t test tissue from deep within the lungs the first time around. Doctors are calling for extensive testing of donor organs, as well as a more thorough exam of nose and throat health to find signs of infection.
“Transplant centers and organ procurement organizations should perform SARS-CoV-2 testing of lower respiratory tract specimens from potential lung donors, and consider enhanced personal protective equipment for health care workers involved in lung procurement and transplantation,” the report reads.
This appears to be the first death from a COVID-19-infected transplant in the nearly 40,000 organ transplants that took place last year in the U.S. The Centers for Disease Control and Prevention took a look at a handful of COVID-19 cases following transplants to determine if donor organs can infect recipients but found that infections were likely a result of exposure from health care facilities or other outside contacts in the eight cases identified.
Lungs were the only organ donated in the Michigan case, so it is unclear as to whether other organs are capable of transmitting the virus and infecting a donor.
“It seems for non-lung donors that it may be very difficult to transmit COVID, even if the donor has COVID,” Kaul told NBC News, adding “The risks of turning down transplants are catastrophic,” he said. “I don’t think patients should be afraid of the transplant process.”
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