Woman dies of COVID-19 after lung transplant. The expert says this is “unusual”, but procedures can “move forward safely.”

The story of a Michigan woman who contracted COVID-19 from a lung transplant and died 60 days later has raised concerns about whether the medical procedure is safe during the pandemic. But experts tell Yahoo Life the incident is exceptionally rare and – out of some 39,000 organ transplants last year in the United States – is the first documented case of transmission of COVID-19 from a donor.

“These events are quite unusual,” says Dr David Klassen, chief medical officer of the United Network for Organ Sharing (UNOS), a non-profit organization in charge of the organ transplant program in the United States. “We are monitoring [cases like this] very carefully as we go along, and that’s certainly a high priority, ”he adds. Klassen says all donors are screened for COVID-19 before a transfer occurs – a process that has been in place since late April – but most testing is done by pharyngeal nasal swab, which may have missed this case.

According to the case report on this incident, published in the American Journal of Transplantation this month, the Michigan woman became critically ill with symptoms of COVID-19 three days after receiving the transplanted lung, which came from another woman, who died in a car crash. The donor’s family said they had shown no signs of the virus in the days leading up to the accident and a nasal swab taken within 48 hours came back negative.

But when the Michigan woman started showing symptoms while testing negative, doctors decided to test her and the donor’s lung fluid and found them positive. Dr Daniel Kaul, director of the infectious disease transplant service at the University of Michigan, told the Washington post that he knew something was wrong. “I was seeing the patient and I was very worried that it could be from the donor because it would be really unusual if it was deep in the lungs but not in the upper respiratory tract. [nose and throat]. “

The story continues

Klassen says a case like this highlights the need for rigorous testing, including – in the case of a lung transplant – using a specialized test to analyze “the secretions that are obtained deep in the lungs.” This test, he says, is not accessible to all hospitals and therefore is not consistently available, which may explain why the woman received lungs carrying COVID-19.

While this story may sound alarming to some, Klassen says that overall, the pandemic has done little to disrupt the organ donation program in the United States. Based on statistics shared with UNOS’s Yahoo Life, 39,000 organ donations were made in 2020, a number comparable to previous years. In total, there were 2,539 lung transplants, 200 fewer than the previous year.

That doesn’t mean there weren’t any obstacles at the start. “When the pandemic first struck – before there was much knowledge about COVID-19 and before adequate testing was put in place, the number of transplants fell by about 50 percent” , Klassen says. “Living donor transplants, which are a little more optional – they’ve ceased entirely across the country for a short time.” But a month after the start of the pandemic, when organizations gained a better understanding of COVID-19 and how to test it, the numbers “bounced back” and hit “the pace we expect them to,” he says. .

Klassen says that with rigorous testing, these rescue procedures can be performed even in the midst of a deadly pandemic – but, as always, it’s a matter of weighing the different options. “I think people need to be realistic about the risks that exist and they need to discuss those risks with their doctors,” Klassen says. “Weigh what their risks are to a given organ and how well they might survive while waiting for another opportunity that may or may not present itself.”

He hopes those who read Michigan’s tragic story will realize that this is unusual and that the vast majority of transplants that have taken place over the past year have had positive results. “I think people should have confidence in the system as a whole,” he says. “It will always be a question of risks and benefits, but I think for the majority of patients, the benefits probably outweigh the risks. Patients and physicians alike need to review every offer with a critical eye, but I think transplants can move forward safely. “

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