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Abstract: SA-PO817

Detection of Transmissible Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) in Blood and Biopsies From Deceased Kidney Donors

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Azhar, Ambreen, Virginia Commonwealth University, Richmond, Virginia, United States
  • Khorsandi, Shiba, Virginia Commonwealth University, Richmond, Virginia, United States
  • Moinuddin, Irfan Ahmed, Virginia Commonwealth University, Richmond, Virginia, United States
  • Molnar, Miklos Zsolt, University of Utah Health, Salt Lake City, Utah, United States
  • Levy, Marlon F., Virginia Commonwealth University, Richmond, Virginia, United States
  • Tanriover, Bekir, Banner University Medical Center Tucson, Tucson, Arizona, United States
  • Gupta, Gaurav, Virginia Commonwealth University, Richmond, Virginia, United States
Background

We recently reported that in United States, 388 organs from SARS-CoV-2 nucleic acid test (NAT) positive 150 donors were procured between Aug 2020 to Sep 2021.Nearly 1 million deaths have been attributed to SARS-CoV-2 pandemic however only selected group of donor organs were assessed for transplantation. Even after procurement, 28% (of 388) organs were discarded. For kidney transplants (KT), commonest reason for relatively high-quality organ discards (35%) was ‘exhaustion of wait list’, indicating reluctance to accept these organs.

Methods

We investigated potential risk of donor transmission of SARS-CoV-2 by a prospective study including 23 KT recipients with prior SARS-CoV-2 vaccination. Donor serum and pre-implantation kidney biopsy tissue were assessed for detection of SARS-CoV-2 via a validated commercially available real-time reverse transcription polymerase chain reaction (RT-PCR) (threshold 73 copies/mL). All recipients had SARS-CoV-2 RT-PCR on plasma and nasopharyngeal swab at Day-7 post-KT.

Results

A total of 23 KT were performed from 22 SARS-CoV-2 NAT positive donors between Nov 2021 and Feb 2022. All 22-donor serum samples and 23 procurement biopsies were negative for SARS-CoV-2, including those from 8 donors with symptomatic disease. Six (of 22 donors; 27%) had death attributable to SARS-CoV-2 complications. Three recipients with asymptomatic donors were diagnosed with clinical SARS-CoV-2 disease at 10, 14, and 23 days post-KT during 4th pandemic surge. Both graft and patient survival rate was 100% at a median 3 month followup. Collation with national ‘Organ Procurement and Transplant Network’ registry showed that majority of other organs from these donors were not procured [zero pancreata, zero lungs, 11 (50%) livers, 19 (86%) hearts]. Among 42 KT [55% (23/42) performed at our center], 10 transplanted livers, and 3 hearts; no graft loss or death was reported.

Conclusion

In this single-center study we report an absence of detectable SARS-CoV-2 virus in donor kidney tissue and plasma from SARS-CoV-2 positive donors.and absence of recipient viremia and nasopharyngeal detectable virus immediately after KT indicating a lack of donor transmission. Our results of excellent graft and patient survival favor utilization of SARS-CoV-2 infected donors.