Utilization of SARS‐CoV‐2‐Positive donors in pediatric renal transplantation

Background As COVID‐19‐positive donors are becoming more common, there is an increasing need for the transplant community to evaluate the safety and efficacy of organ transplant from a SARS‐CoV‐2‐infected donor. Methods Here we describe outcomes of two pediatric kidney transplant recipients who were...

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Bibliographic Details
Published in:Pediatric transplantation 2023-08, Vol.27 (5), p.e14451-n/a
Main Authors: Pizzo, Helen, Soni, Priya R., Nadipuram, Santhosh, Garrison, Jonathan, Jordan, Stanley C., Puliyanda, Dechu
Format: Article
Language:English
Subjects:
Case Report
Child
COVID-19
cycle threshold
Donors
Humans
Immunoglobulin G
Immunoglobulins
infection
Intravenous administration
Kidney Transplantation
Kidney transplants
Organ Transplantation
outcomes
Pediatrics
Renal function
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Tissue Donors
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Summary:Background As COVID‐19‐positive donors are becoming more common, there is an increasing need for the transplant community to evaluate the safety and efficacy of organ transplant from a SARS‐CoV‐2‐infected donor. Methods Here we describe outcomes of two pediatric kidney transplant recipients who were vaccinated against COVID‐19 and received their allograft from a SARS‐CoV‐2‐positive donor. Results Both donors did not die from a COVID‐19‐related illness; the first donor had 1 week of COVID‐19 symptoms 4 weeks prior to donation and the second was asymptomatic. Donor 1 had a Ct of 33.4 at 3 days and Donor 2 with a Ct of 37.2 at 16 days prior to donation. The first recipient was positive for SARS‐CoV‐2 anti‐spike IgG on the day of transplant, but the second patient was negative and both patients received IVIg perioperatively. There was no evidence of SARS‐CoV‐2 transmission or compromised renal function at 86‐ and 80‐day post‐transplant, respectively. Conclusions This case series suggests favorable short‐term outcomes with accepting SARS‐CoV‐2‐positive donors for pediatric renal transplantation, after thorough evaluation of the donor's risk for transmission, assessing the recipient's serologic status to SARS‐CoV‐2, and considering pre‐emptive measures to mitigate the risk for severe COVID‐19 should the recipient acquire donor‐derived SARS‐CoV‐2.
ISSN:1397-3142
1399-3046
DOI:10.1111/petr.14451