A lung transplant procedure last fall in Michigan resulted in the death of the patient and the illness of a surgeon involved by COVID-19, after both donor and recipient initially tested negative. The doctors say this is the first documented case of a transplant recipient contracting the virus from a donor.
The lung donor was an upper Midwest woman, according to doctors, and had suffered a serious brain injury in a car accident in November. He quickly advanced to “brain death,” according to The report published recently, and was tested for COVID-19 before his organs were donated.
His family said he showed no signs of COVID-19 symptoms in the days leading up to the accident and that he had no travel history.
“We would not have used the lungs if we had had a positive Covid test,” said Dr. Daniel Kaul, a co-author of the report in the American Journal of Transplantation detailing the case, and the director of the Mighigan Mediciden infectious disease transplant service told NBC News.
The recipient had chronic obstructive pulmonary disease and was tested for COVID-19 prior to transplantation at Ann Arbor University Hospital.
“All the tests that we normally do and can do, we did,” Kaul said.
Three days after the procedure, the recipient developed a fever, her blood pressure dropped, and she had trouble breathing. Images of her new lungs showed signs of infection.
Test samples from her new lungs tested positive for COVID-19.
Four days after the procedure, the surgeon who had manipulated the donor’s lungs tested positive for COVID-19.
Searching for answers, the doctors returned to the samples taken from the donor. A test done 48 hours after the lungs were obtained came back negative for COVID-19. However, they were able to analyze a sample taken from deep within the donor’s lungs. That sample was positive.
Genetic testing showed that both the surgeon and the recipient had been infected by the donor.
The transplant recipient’s condition worsened and, 61 days after the lung transplant procedure, she died.
The surgeon has recovered.
While the doctors involved in studying this incident say this is the first confirmed case of COVID-19 transmission from an organ transplant, other cases have been suspected.
the CDC recently analyzed eight incidents since the beginning of the pandemic, however, determined that the most likely source of infection was exposure in the community or health care setting.
The doctors who wrote the report, from the University of Michigan, ask for caution and more tests during transplants.
“Transplant centers and organ procurement organizations should conduct SARS-CoV-2 testing of lower respiratory tract specimens from potential lung donors and consider improved personal protective equipment for healthcare workers involved in obtaining and lung transplantation, ”the report’s authors state.
They also noted that because both the donor and the recipient had tested negative for COVID-19, following the accepted protocol, healthcare workers involved in the procedure were not required to wear N95 masks and eye protection as part of your PPE.
The study encourages transplant centers to consider the benefits of N95 masks and eye protection during transplantation, even with negative tests for COVID-19.
No other organs from the donor were used.