The story of a woman in Michigan who contracted COVID-19 from a lung transplant and died 60 days later raised concerns about whether the medical procedure is safe during the pandemic. But experts tell Yahoo Life that the incident is exceptionally rare and – out of nearly 39,000 organ transplants last year in the United States – it is the first documented case of COVID-19 being transmitted by a donor.
“These events are quite unusual,” said Dr. David Klassen, medical director for the United Network for Organ Sharing (UNOS), a nonprofit organization responsible for the United States organ transplant program. “We are monitoring [cases like this] very carefully as we go, and this is certainly a high priority, “he adds. Klassen says that all donors are selected for COVID-19 before a transfer takes place – a process that has been in place since the end of April – but that most tests done using a pharyngeal nasal swab, which may have failed in this case.
According to the case report on this incident, published in the American Journal of Transplantation this month, the Michigan woman became seriously ill with symptoms of COVID-19 three days after receiving the transplanted lung, which came from another woman, who had died in a car accident. The donor’s family said she showed no signs of the virus in the days before the accident and that a nasal smear taken in 48 hours was negative.
But when the Michigan woman started showing symptoms while the test was negative, doctors decided to test her and donor’s lung fluid and found they were positive. Dr. Daniel Kaul, director of the transplant infectious disease service at the University of Michigan, told the Washington Post that he knew something was not right. “I was attending to the patient and was very concerned that it might have come from the donor, because it would be really unusual for him to be at the bottom of the lungs, but not in the upper respiratory tract. [nose and throat]. “
Klassen says that a case like this highlights the need for rigorous testing, including – in the case of a lung transplant – the use of a specialized test to analyze “secretions that are obtained inside the lungs”. This test, he says, is not something that all hospitals have access to and therefore is not uniformly available, which may explain why the woman received lungs that carried COVID-19.
While this story may seem alarming to some, Klassen says that, overall, the pandemic has done little to disrupt the United States’ organ donation program. Based on statistics shared with UNOS Yahoo Life, there were 39,000 organ donations made in 2020, a number that is on par with previous years. In total, there were 2,539 lung transplants, only 200 less than the previous year.
This is not to say that there were no obstacles in the beginning. “When the pandemic first hit – before there was much knowledge about COVID-19 and before the proper tests were implemented, the number of transplants decreased by about 50 percent,” said Klassen. “Transplants from living donors, which are a little more optional – have completely stopped across the country for a short period of time.” But a month after the pandemic started, when organizations gained a better understanding of COVID-19 and how to test it, the numbers “recovered” and reached “the pace we hope they will be,” he says.
Klassen says that with rigorous testing, these life-saving procedures can be carried out even in the midst of a deadly pandemic – but that, as always, is about weighing the different options. “I think people need to be realistic about the risks that exist and need to discuss those risks with their doctors,” says Klassen. “Weigh what are the risks of any organ and how well they can survive waiting for another opportunity that may or may not come.”
He expects those reading about Michigan’s tragic history to realize that it is unusual and that the vast majority of transplants that took place last year have had positive results. “I think people should have confidence in the system as a whole,” he says. “It will always be a question of risks and benefits, but I think for most patients, the benefits probably outweigh the risks. Patients and doctors need to examine each offer critically, but I think that transplants can move forward safely.”
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