Home Health Hearts from COVID-19-positive donors may be safe for transplantation

Hearts from COVID-19-positive donors may be safe for transplantation

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November 23, 2022

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Kim, ST et al. Abstract 563. Presented at the American Heart Association Scientific Sessions. November 5-7, 2022. Chicago (hybrid conferencing).

Disclosure:
Kim has not reported any relevant financial disclosures.


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CHICAGO — The short-term results for heart transplant recipients who received hearts from people with COVID-19 are “encouraging,” researchers reported at the American Heart Association’s scientific session.

Samuel T. Kim, Bachelor, Medical students and colleagues at UCLA’s David Geffen School of Medicine have announced the results of the first 110 COVID-19-positive donor heart transplants in the United States.

A graphical depiction of the source cited in the article

“Patients who receive heart transplants from COVID-19-positive donors have similar in-hospital and 30-day post-transplant mortality rates and complication rates such as graft failure and pulmonary complications. We therefore found preliminary evidence based on national data that COVID-19-positive donor hearts can be safely and effectively used for heart transplantation without short-term adverse effects.” Kim told Helio.

short-term results

Researchers performed a retrospective analysis of the Union Network for Organ Sharing (UNOS) database. adult heart transplant Performed in the United States from January 2020 to March 2022.

“Heart transplantation remains the gold standard treatment for end-stage heart failure in the United States. This is an ongoing challenge: with the onset of the COVID-19 pandemic, the proportion of donors who test positive for COVID-19 is increasing, making donors generally unsuitable for transplantation. “We started using COVID-19-positive donor hearts for heart transplantation in 12 months and have reported good results. Kim told Helio.

The use of COVID-19 positive donor hearts increased during the study period. Results showed that most COVID-19-positive donor heart transplants were performed in the southeastern, mid-Atlantic, and Midwestern United States.

Recipients of COVID-19-positive donor hearts were younger than those who received COVID-19-negative hearts (age 54 vs. 57), although women (24% vs. 27%) and ‘non-white’ proportions was at the same level. According to the results, recipients by race (38% vs 39%).

The investigators then performed nearest-neighbour propensity score matching with 100 pairs of matched recipients that compared COVID-19-positive donor hearts with non-positive hearts and found no significant differences in short-term outcomes between groups. I discovered that

  • The 30-day mortality was 3% in both groups (P = .99);
  • Three-month survival was 88% vs 94% (P = .twenty three);
  • Graft failure rate was 1% vs 0% (P = .99);
  • Postoperative stroke occurred in 1% of each group (P = .99);
  • Postoperative dialysis was required in 14% vs. 11% (P = .52); and
  • Duration of stay was 15 days in both groups (P = .Four).

To date, eight recipients of COVID-19-positive donor hearts have died. Deaths from lungs and infections were rare in these patients, according to the researchers.

“We were surprised by this finding because we expected that the presence of COVID-19 in the donor would make a difference in the recipient’s transplant outcome. “It’s probably going to be a big problem for recipients who accept donors with COVID-19. But in our study, we didn’t see any difference in results between the groups,” Kim told Helio.

Continuous monitoring is guaranteed

Several case series have documented the safe and effective use of COVID-19-positive organs for heart transplants, Kim said.

“However, nationally representative analyzes of the safety and efficacy of COVID-19-positive donor heart transplantation are lacking,” said Kim. “Our study is the first to report nationwide results of COVID-19-positive donor hearts in heart transplantation and uses the largest sample size to date.”

However, according to Kim, data on long-term outcomes for recipients of COVID-19-positive hearts are still limited.

“A concern may be that while COVID-19-positive donor organs may pose no short-term risk to the recipient, long-term outcomes may be compromised. , because of the short duration of COVID-19, it cannot be ruled out: 19 positive donor organ transplants have been performed in the United States,” Kim said.

The researchers concluded that future research should focus on continuous monitoring. long term results and potential complications.

“These findings may provide evidence that patients can be more proactive about accepting COVID-19-positive donors when they are hospitalized. Heart transplant organs are desperately neededGiven the large number of donors who test positive for COVID-19, this could help address organ shortages in heart transplants. This also suggests that the increased risk of using asymptomatic, COVID-19-positive donors for heart transplantation could be ameliorated by less time waiting for hearts on the recipient side and more timely surgery. “It may provide evidence that the highest degree of

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