ANN ARBOR, MI – A woman who received a double lung transplant at the University of Michigan died two months later after contracting COVID-19 from the donor’s lungs, according to a study published in the American Journal of Transplantation.
This is the first known case of transmission from donor to recipient of COVID-19, according to Daniel Kaul, author of the study and professor of internal medicine at UM.
The organ donor was a woman from the upper Midwest who suffered a severe brain injury in a car accident, says the study, adding that the woman quickly evolved to brain death during a two-day hospital stay.
The doctors performed the COVID-19 test within 48 hours of acquiring the organs for transplant and the test was negative, according to the study. CT scans of the lungs showed no evidence to suggest COVID-19, and the nose and throat smears were negative, Kaul said.
“The family was unaware of any donor symptoms or exposure suggestive of COVID-19, so (the donor) was asymptomatic, as far as we can tell,” said Kaul.
The lung receptor was tested for COVID-19 12 hours before transplantation and its test was negative, notes the study. There were no complications with the procedure, but the recipient developed complications several days later.
The recipient then received an initial positive COVID-19 test, so doctors checked the residual fluid available at the bottom of the donor’s lungs, which was obtained before acquiring the organs, and which also tested positive, said Kaul.
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 says.
Unexpected transmission of infection from the donor to the recipient is uncommon, occurring in less than 1% of transplant recipients, according to the study. However, emerging pathogens pose specific challenges in assessing the risk of disease transmission, including recent diseases like 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 collection, but prepared the lungs for the implant and performed the transplant procedure, says the study.
No other exposed health workers have been diagnosed with COVID-19 associated with this event, the study says. No other organs were donated in the case and the study does not provide information on the risk of transmission to non-pulmonary recipients.
This type 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 see this as a reason to refuse an organ,” said Kaul. “This is a rare event and the first seen in almost 40,000 transplants done in the 2020 calendar year. The risks of failure of organs not treated by transplantation are much greater than 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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