Early success transplanting kidneys from donors with new SARS-CoV-2 RNA positivity: A report of 10 cases
Early success transplanting kidneys from donors with new SARS-CoV-2 RNA positivity: A report of 10 cases
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DOI：
10.1111/ajt.16765
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发表时间：
2021-07-23
影响因子：
8.8
通讯作者：
Wee, Alvin
中科院分区：
文献类型：
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作者：
Koval, Christine E.;Poggio, Emilio D.;Wee, Alvin
由于可能将疾病传播给受体，因此建议不要移植患有活动性SARS-CoV-2感染的供体的实体器官。然而，除了肺，可移植器官的生产性感染的结论性数据并不存在。虽然这些数据还在等待中，但器官短缺每年继续夺走数千人的生命。在这种情况下，我们提出了一种策略，从SARS-CoV-2感染的供体中移植健康的肺外器官。我们于2021年初移植了5名已故捐赠者的10个肾脏，在捐赠者评估期间新检测到SARS-CoV-2 RNA。肾供体特征指数范围为3%至56%。所有的器官都被其他多个中心拒绝了。由于没有明确的体征或症状，无法证实SARS-CoV-2感染时间的准确性。经过8-16周的随访，所有10例患者和同种异体移植物的结局都很好。所有人都没有供体来源的SARS-CoV-2感染的体征或症状。我们的研究结果提出了关于潜在器官捐献者中SARS-CoV-2 RNA检测性质的重要问题，并表明对疾病传播风险低的特别好的肺外器官的利用不足。
Transplantation of solid organs from donors with active SARS-CoV-2 infection has been advised against due to the possibility of disease transmission to the recipient. However, with the exception of lungs, conclusive data for productive infection of transplantable organs do not exist. While such data are awaited, the organ shortage continues to claim thousands of lives each year. In this setting, we put forth a strategy to transplant otherwise healthy extrapulmonary organs from SARS-CoV-2-infected donors. We transplanted 10 kidneys from five deceased donors with new detection of SARS-CoV-2 RNA during donor evaluation in early 2021. Kidney donor profile index ranged from 3% to 56%. All organs had been turned down by multiple other centers. Without clear signs or symptoms, the veracity of timing of SARS-CoV-2 infection could not be confirmed. With 8-16 weeks of follow-up, outcomes for all 10 patients and allografts have been excellent. All have been free of signs or symptoms of donor-derived SARS-CoV-2 infection. Our findings raise important questions about the nature of SARS-CoV-2 RNA detection in potential organ donors and suggest underutilization of exceptionally good extrapulmonary organs with low risk for disease transmission.