Early Outcomes of Adult Heart Transplantation From COVID-19 Infected Donors
Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved..
BACKGROUND: There is a paucity of data on heart transplantation (HT) using COVID-19 donors.
OBJECTIVES: This study investigated COVID-19 donor use, donor and recipient characteristics, and early post-HT outcomes.
METHODS: Between May 2020 and June 2022, study investigators identified 27,862 donors in the United Network for Organ Sharing, with 60,699 COVID-19 nucleic acid amplification testing (NAT) performed before procurement and with available organ disposition. Donors were considered "COVID-19 donors" if they were NAT positive at any time during terminal hospitalization. These donors were subclassified as "active COVID-19" (aCOV) donors if they were NAT positive within 2 days of organ procurement, or "recently resolved COVID-19" (rrCOV) donors if they were NAT positive initially but became NAT negative before procurement. Donors with NAT-positive status >2 days before procurement were considered aCOV unless there was evidence of a subsequent NAT-negative result ≥48 hours after the last NAT-positive result. HT outcomes were compared.
RESULTS: During the study period, 1,445 "COVID-19 donors" (COVID-19 NAT positive) were identified; 1,017 of these were aCOV, and 428 were rrCOV. Overall, 309 HTs used COVID-19 donors, and 239 adult HTs from COVID-19 donors (150 aCOV, 89 rrCOV) met study criteria. Compared with non-COV, COVID-19 donors used for adult HT were younger and mostly male (∼80%). Compared with HTs from non-COV donors, recipients of HTs from aCOV donors had increased mortality at 6 months (Cox HR: 1.74; 95% CI: 1.02-2.96; P = 0.043) and 1 year (Cox HR: 1.98; 95% CI: 1.22-3.22; P = 0.006). Recipients of HTs from rrCOV and non-COV donors had similar 6-month and 1-year mortality. Results were similar in propensity-matched cohorts.
CONCLUSIONS: In this early analysis, although HTs from aCOV donors had increased mortality at 6 months and 1 year, HTs from rrCOV donors had survival similar to that seen in recipients of HTs from non-COV donors. Continued evaluation and a more nuanced approach to this donor pool are needed.
| Errataetall: |
CommentIn: J Am Coll Cardiol. 2023 Jun 20;81(24):2358-2360. - PMID 37316115 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:81 |
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| Enthalten in: |
Journal of the American College of Cardiology - 81(2023), 24 vom: 20. Juni, Seite 2344-2357 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Madan, Shivank [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 donors |
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| Anmerkungen: |
Date Completed 16.06.2023 Date Revised 12.11.2023 published: Print-Electronic CommentIn: J Am Coll Cardiol. 2023 Jun 20;81(24):2358-2360. - PMID 37316115 Citation Status MEDLINE |
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| doi: |
10.1016/j.jacc.2023.04.022 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 245 | 1 | 0 | |a Early Outcomes of Adult Heart Transplantation From COVID-19 Infected Donors |
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| 500 | |a Date Completed 16.06.2023 | ||
| 500 | |a Date Revised 12.11.2023 | ||
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| 500 | |a CommentIn: J Am Coll Cardiol. 2023 Jun 20;81(24):2358-2360. - PMID 37316115 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: There is a paucity of data on heart transplantation (HT) using COVID-19 donors | ||
| 520 | |a OBJECTIVES: This study investigated COVID-19 donor use, donor and recipient characteristics, and early post-HT outcomes | ||
| 520 | |a METHODS: Between May 2020 and June 2022, study investigators identified 27,862 donors in the United Network for Organ Sharing, with 60,699 COVID-19 nucleic acid amplification testing (NAT) performed before procurement and with available organ disposition. Donors were considered "COVID-19 donors" if they were NAT positive at any time during terminal hospitalization. These donors were subclassified as "active COVID-19" (aCOV) donors if they were NAT positive within 2 days of organ procurement, or "recently resolved COVID-19" (rrCOV) donors if they were NAT positive initially but became NAT negative before procurement. Donors with NAT-positive status >2 days before procurement were considered aCOV unless there was evidence of a subsequent NAT-negative result ≥48 hours after the last NAT-positive result. HT outcomes were compared | ||
| 520 | |a RESULTS: During the study period, 1,445 "COVID-19 donors" (COVID-19 NAT positive) were identified; 1,017 of these were aCOV, and 428 were rrCOV. Overall, 309 HTs used COVID-19 donors, and 239 adult HTs from COVID-19 donors (150 aCOV, 89 rrCOV) met study criteria. Compared with non-COV, COVID-19 donors used for adult HT were younger and mostly male (∼80%). Compared with HTs from non-COV donors, recipients of HTs from aCOV donors had increased mortality at 6 months (Cox HR: 1.74; 95% CI: 1.02-2.96; P = 0.043) and 1 year (Cox HR: 1.98; 95% CI: 1.22-3.22; P = 0.006). Recipients of HTs from rrCOV and non-COV donors had similar 6-month and 1-year mortality. Results were similar in propensity-matched cohorts | ||
| 520 | |a CONCLUSIONS: In this early analysis, although HTs from aCOV donors had increased mortality at 6 months and 1 year, HTs from rrCOV donors had survival similar to that seen in recipients of HTs from non-COV donors. Continued evaluation and a more nuanced approach to this donor pool are needed | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 donors | |
| 650 | 4 | |a donor characteristics | |
| 650 | 4 | |a heart transplantation | |
| 650 | 4 | |a transplant outcomes | |
| 700 | 1 | |a Chan, Marvyn Allen G |e verfasserin |4 aut | |
| 700 | 1 | |a Saeed, Omar |e verfasserin |4 aut | |
| 700 | 1 | |a Hemmige, Vagish |e verfasserin |4 aut | |
| 700 | 1 | |a Sims, Daniel B |e verfasserin |4 aut | |
| 700 | 1 | |a Forest, Stephen J |e verfasserin |4 aut | |
| 700 | 1 | |a Goldstein, Daniel J |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Snehal R |e verfasserin |4 aut | |
| 700 | 1 | |a Jorde, Ulrich P |e verfasserin |4 aut | |
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