Donor Hearts With COVID Are Safe for Transplant

The pandemic may have caused delays for a person with heart failure who was in urgent need of a new heart because possible donors tested positive for COVID-19.

Data from a recent study suggests that hearts from COVID-19 positive donors may be as safe to transplant as those from people without the virus, even though some centres started admitting these hearts for transplantation nevertheless.

According to study author Samuel Kim, a third-year medical student at the David Geffen School of Medicine at the University of California, Los Angeles, “these findings suggest that we may be able to be more aggressive about accepting donors that are positive for COVID-19 when patients are in dire need of an organ for heart transplantation.”

The United Network for Organ Sharing database was used to analyse the cases of transplant recipients in the first 30 days following their operation for the study, which will be presented at the American Heart Association’s annual meeting Nov. 5-7 in Chicago.

All adult heart transplants performed in the United States between February 2021 and March 2022 were listed in the database. A total of 3,289 hearts were donated, and 84 of those came from donors who tested positive for COVID.

Researchers discovered that the rates of inpatient and 30-day mortality for both groups of organ transplant recipients were comparable. Furthermore, the rates of complications were comparable. This included organ rejection or lung problems.

The typical hospital stay for patients who received hearts from COVID-19-free donors was 17 days. For individuals who received a heart from a COVID-positive donor, it was 15 days.

2.4% of recipients of organs from COVID-19-positive donors experienced organ rejection. In 1% of the other cases, it occurred.

Approximately 97% of recipients of hearts from donors who were virus-free and 96.1% of recipients of hearts from virus-carriers both made a full recovery.

According to the research, none of the four patients who passed away after receiving a heart from a COVID-positive donor perished from respiratory illnesses or infections.

The findings surprised the researchers.

In particular, Kim stated in a news release from the cardiac association that “we expected death from respiratory or lung-related reasons would be a problem among recipients receiving donor hearts with COVID-19.” “However, we discovered no such changes, and in fact, this study provides preliminary evidence that donor hearts with COVID-19 status may be equally safe for heart transplantation as hearts without COVID-19 status.”

Guidelines for treating heart failure from the American Heart Association, American College of Cardiology, and Heart Failure Society of America as of 2022 persons who have advanced (stage D) heart failure should be advised to have a heart transplant.

By stage D, persons experience breathing difficulties, exhaustion, and swelling that interfere with regular activities. This may result in repeated hospital stays.

The American Heart Association’s Heart Disease and Stroke Statistics-2022 show that 3,658 Americans got hearts in 2020, up from 1,676 in 1988.

Currently, more than 3,400 Americans are in need of a heart.

“There are still not enough organs available from donors for individuals in need of transplants, despite the increased demand for this treatment. The COVID-19 pandemic made problems worse with a higher proportion of donors testing positive for COVID-19, which normally disqualifies the donors for transplantation, “said Kim. However, several academic institutions have started using donor hearts that tested positive for COVID-19 recently, and they have reported successful results.

However, the study’s scope was limited. Researchers added that longer-term studies are required to determine how patients who received hearts from COVID-19-positive donors fare more than 30 days following surgery.

According to Dr. Eldrin Lewis, an expert in advanced heart failure and heart transplants at Stanford University in California and the Simon H. Stertzer M.D. “These findings give evidence that outcomes were similar at 30-days post-transplant among patients who received COVID-19-positive donor hearts, therefore the potential dangers appear to be fewer than expected,” said Professor of Cardiovascular Medicine and Chair of the Division of Cardiovascular Medicine.

Since people frequently get sicker as heart failure advances while waiting for a donor heart to become available, Lewis noted in the release, “this may help to address the shortages in donor hearts for transplantation and minimise waiting periods.”

Up until they are published in a peer-reviewed journal, findings presented at medical gatherings are regarded as preliminary.

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For more information on heart failure, visit the American National Heart, Lung, and Blood Institute.

SOURCE: News release from the American Heart Association

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