Researchers have suggested in a study that the woman, who was not named, is the first proven case of transmission from an organ transplant in the United States, raising questions on appropriate COVID screenings for potential donors.
The researchers who conducted the study noted that one of the surgeons who handled the donor lungs was also infected, proving ‘donor origin of recipient and health care worker infection.’
A surgeon became sick and tested positive for COVID-19 four days after handing the donor’s lungs but recovered, according to the study – which was published in the American Journal of Transplantation.
A Michigan woman contracted COVID-19 and died last fall two months after a double-lung transplant at University Hospital in Ann Arbor, pictured
Dr. Daniel Richard Kaul, pictured, suggested in a study that health care workers perform COVID tests on samples taken from deep within donor lungs
The case, being the only confirmed transmission among nearly 40,000 transplants in 2020, appears to be an isolated occurrence, according to Kaiser Health News.
The donated lungs came from a woman from the Upper Midwest who died after suffering a severe brain injury in a car accident.
The donor’s lungs were then transplanted into a woman with chronic obstructive lung disease, known as COPD, at University Hospital in Ann Arbor.
Dr. Daniel Richard Kaul, director of the Transplant Infectious Disease Service at the University of Michigan Medical School, said nose and throat samples routinely collected from organ donors and recipients tested negative for COVID-19.
‘We would absolutely not have used the lungs if we’d had a positive COVID test,’ Kaul told Kaiser Helath News.
He added: ‘All the screening that we normally do and are able to do, we did.’
By the third day after the transplant, the woman ‘developed worsening fever, hypotension, and ventilator requirements’ and imaging showed a lung infection, according to the study.
When the patient started presenting with septic shock, doctors decided to send samples from her lungs for coronavirus testing – which came back positive.
Doctors returned to samples from the transplant donor’s nose and throat, which had tested negative for COVID-19.
‘History obtained from family revealed no history of travel or any recent fever, cough, headache, or diarrhea,’ the study reads.
‘It is unknown if the donor had any recent exposures to persons known or suspected to be infected with SARS-CoV-2.’
Doctors then tested a sample of fluid taken from deep within the donated lungs before they were implanted, which later came back positive for the virus.
Researchers said that genetic screening revealed that ‘both the transplant recipient and the surgeon acquired SARS-CoV-2 from the donor lungs.’
The woman’s health quickly deteriorated and she was not considered a candidate for re-transplantation. Doctors said support was withdrawn and she died on 61 days after the transplant.
The study concluded that donor-derived infection from COVID-19 ‘has significant implications for the health of the recipient,’ but also for health care workers who may be exposed prior to the recipient’s diagnosis.
The Organ Procurement and Transplantation Network, which oversees transplants, does not require organ donors to have been tested for COVID-19, according to Kaiser Health News.
‘Transplant centers and organ procurement organizations should consider the possible 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,’ according to the study.