Outcomes of lung transplantation from SARS-CoV-2 positive donors during the Omicron wave

JHLT Open Pub Date : 2025-03-18 DOI:10.1016/j.jhlto.2025.100249

Sonya M. Kothadia , Cameron R. Wolfe , Arthur W. Baker , Katherine A. Young , John M. Reynolds , Matthew G. Hartwig , Amanda Rooney , Madeleine R. Heldman

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Abstract

Early observations of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) transmission via lung transplantation have led to frequent discard of lungs from donors with positive SARS-CoV-2 tests. We compared survival between lung transplant recipients (LUTRs) with SARS-CoV-2 (+) (n = 11) and SARS-CoV-2 (-) donors (n = 192) transplanted from January 30, 2022 to March 31, 2024. Three of the 11 SARS-CoV-2 (+) donors had positive lower respiratory tract (LRT) tests. Two of their 3 recipients developed post-transplant SARS-CoV-2 infections, including one LUTR who died 11 days post-transplant. LUTRs with SARS-CoV-2 (+) donors had higher 30-day mortality (2/11 [18.2%] vs 7/192 [3.6%], p = 0.02), but there was no significant difference in 1-year mortality (2/11 [18.2%] vs 27/192 [14.1%], p = 0.56). Only 3 (27%) LUTRs with SARS-CoV-2 (+) donors developed acute cellular rejection in the first post-transplant year, and none were diagnosed with chronic lung allograft dysfunction. These findings support consideration of SARS-CoV-2 (+) lung donors, especially when LRT testing is negative.

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欧米克隆波期间SARS-CoV-2阳性供体肺移植的结果

早期观察到严重急性呼吸综合征冠状病毒-2 （SARS-CoV-2）通过肺移植传播，导致SARS-CoV-2检测呈阳性的供体经常丢弃肺。我们比较了2022年1月30日至2024年3月31日移植的SARS-CoV-2 (+) （n = 11）和SARS-CoV-2（-）供体（n = 192）肺移植受者（LUTRs）的生存率。11名SARS-CoV-2（+）献血者中有3人下呼吸道（LRT）检测呈阳性。他们的3名受者中有2名在移植后出现了SARS-CoV-2感染，其中一名lur患者在移植后11天死亡。SARS-CoV-2（+）供体的lutr患者30天死亡率较高（2/11 [18.2%]vs 7/192 [3.6%], p = 0.02），但1年死亡率无显著差异（2/11 [18.2%]vs 27/192 [14.1%], p = 0.56）。只有3例（27%）具有SARS-CoV-2（+）供体的LUTRs在移植后的第一年出现急性细胞排斥反应，并且没有人被诊断为慢性同种异体肺移植功能障碍。这些发现支持考虑SARS-CoV-2（+）肺供体，特别是当LRT检测呈阴性时。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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JHLT Open

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