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Lung transplant recipient at University of Michigan receives COVID-19 from donor, dies two months later

ANN ARBOR, MI – A woman who received a dual lung transplant at the University of Michigan died two months later after receiving COVID-19 from the donor’s lungs, according to a study in the American Journal of Transplantation.

This is the first known case of donor-to-recipient transmission of COVID-19, according to Daniel Kaul, the study’s author and professor of internal medicine at UM.

The organ donor was a woman from the Upper Midwest who suffered a serious brain injury in a car accident, the study says, adding that the woman quickly developed into brain death during a two-day hospital stay.

Doctors performed COVID-1

9 tests within 48 hours of acquiring the organs for transplantation, and tests came back negative, according to the study. CT scans of the lungs showed no evidence to suggest COVID-19, and nasal and throat swabs were negative, Kaul said.

“The family was not aware of any donor symptoms or exposure suggesting COVID-19, so (the donor) was asymptomatic as far as we can see,” Kaul said.

The lung recipient was tested for COVID-19 12 hours before the transplant and her test came back negative, the study notes. There were no complications with the procedure, but the recipient developed several complications days after.

The recipient then received an initial positive COVID-19 test, so doctors checked residual fluid they had available from deep inside the donor lungs, which was obtained before the acquired organs, and it also tested positive, Kaul said.

The recipient died 61 days after the transplant, according to the study. She was still COVID-19 positive 60 days after the transplant, the study said.

Unexpected transmission of infection from donor to recipient is unusual, occurring in less than 1% of transplant recipients, according to the study. However, new pathogens pose particular challenges in assessing disease transmission risk, including recent diseases such as H1N1, West Nile virus, Ebola and Zika, the study notes.

Four days after the transplant operation, a thoracic surgeon tested positive for COVID-19 according to the study. The surgeon was not present at the time of purchase, but prepared the lungs for implantation and performed the transplant procedure, the study said.

No other exposed health worker was diagnosed with COVID-19 associated with this event, the study says. No other organs were donated in the case and the study has no information on the risk of transmission to non-lung recipients.

This kind of incident should not make anyone afraid to donate life-saving organs, Kaul said.

“I think it is very important that patients with organ failure waiting for a transplant do not take this as a reason to reject an organ,” Kaul said. “This is a rare event, and the first observed in nearly 40,000 transplants performed in the calendar year 2020. The risk of organ failure not treated by transplantation far outweighs the risk of getting COVID-19 from a donor.”

There was a big reduction in the number of transplants at UM and across the country in the spring of 2020, but it has since returned to normal levels, Kaul said.


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