A lung transplant procedure last fall in Michigan resulted in the death of the patient and the illness of a surgeon involved in COVID-19, after both the donor and recipient initially gave a negative result. Doctors say this is the first documented case of a transplant recipient contracting a donor virus.
According to doctors, the lung donor was a woman from the Northwest, who had suffered a serious brain injury in a car accident in November. He quickly advanced to “brain death,” according to the report was recently published and COVID-19 was tested before donating its organs.
Her family said she showed no signs of COVID-19 symptoms in the days before the accident and had no travel history.
“We would not have used our lungs at all if we had had a positive Covid test,” said Dr. Daniel Kaul, who co-authored the report in American Journal of Transplantation detailing the case, and the director of the Mighigan Mediciden Transplant Infectious Diseases 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.
“We did all the projection we normally do and we’re able to do that,” Kaul said.
Three days after the procedure, the recipient had a fever, her blood pressure dropped and she had difficulty breathing. Images of his new lungs showed signs of infection.
Test samples from his new lungs returned positive for COVID-19.
Four days after the procedure, the surgeon who had manipulated the donor’s lungs tested positive for COVID-19.
In search of answers, doctors returned to the donor’s samples. A test performed 48 hours after procuring the lungs had been negative for COVID-19. However, they were able to test a sample extracted from deep within the donor’s lungs. This sample came back positive.
Genetic testing showed that the surgeon and recipient had been infected by the donor.
The condition of the transplant recipient worsened and, 61 days after the lung transplant procedure, he died.
The surgeon has recovered.
Although doctors involved in the study of this incident say that this is the first confirmed case of COVID-19 transmission from an organ transplant, other cases have been suspected.
He CDC recently eight incidents since the onset of the pandemic were examined, although they determined that the most likely source of infection was exposure to the community or health care.
Doctors who wrote the report, from the University of Michigan, call for caution and more testing during transplants.
“Transplant centers and organ procurement organizations should perform SARS-CoV-2 testing of lower respiratory tract samples from potential lung donors and consider improved personal protective equipment for health workers involved in acquisition and lung transplantation, ”the report’s authors state.
They also noted that both the donor and the recipient had tested negative for COVID-19, following the accepted protocol, health workers involved in the procedure should not wear N95 masks and eye protection as part of their PPE.
The study encourages transplant centers to consider the benefits of N95 masks and eye protection during transplantation, even with negative COVID-19 tests.
No other donor organs were used.