A woman in Michigan has died after receiving a lung transplant from a donor infected with COVID-19.
A woman with chronic obstructive lung disease thought the worst was behind her when doctors found her a donor in the middle of a pandemic. However, in a tragic twist of events, the lung transplanted ended up claiming her life from COVID-19. Doctors in Michigan, US, believe it is the first proven case of donor-to-recipient transmission of COVID-19.
According to the case study, the donor had passed away from a severe brain injury due to a road traffic accident. Although her CT scan on the day of admission consolidation within the right lung, the radiologist blamed it on lung collapse and pulmonary bruising. Moreover, the woman had shown no symptoms and a nasal swab tested for SARs-CoV-2 had come back negative. Therefore, doctors at the University of Michigan Medical School went ahead with the transplant.
We would absolutely not have used the lungs if we’d had a positive Covid test. All the screening that we normally do and are able to do, we did
Daniel Kaul, MD, co-author of the study
The recipient had also received a negative SARS-CoV-2 test 12 hours before the transplant. However, despite the negative tests and an uneventful procedure, the patient developed fever, low blood pressure and breathing difficulties on post-transplant day 3. Doctors then performed a CT scan that revealed a lung infection. As her condition worsened doctors planned for bronchoscopy and collected bronchoalveolar lavage samples from both lungs. Both of which came back positive for the coronavirus.
Despite receiving a multitude of COVID-19 treatments, the lung transplant recipient passed away 61 days after her transplant.
Surgeon on Transplant Team Also Infected
However, the transplant recipient was not the only one who was affected by the procedure. A doctor, part of the transplant team who had prepared the lungs, also developed COVID-19 after the procedure. But he recovered soon after.
According to the case study, the doctors had not worn N95 masks or eye protection during the procedure. This is because the hospital’s protocols made it optional in cases where both donor and recipient tested negative for the virus. Therefore, it is highly likely that the doctor was potentially exposed to infected material from the donor’s lungs.
In conclusion, authors of the study call for testing samples from the donor’s lower respiratory tract along with the nose and throat. Moreover, more than one sample should be collected as part of laboratory testing.
Cases of donor-to-recipient transmission of infections are extremely rare and occur in less than 1% of all transplants. Therefore, Dr Daniel Kaul, director of Michigan Medicine’s transplant infectious disease service, believes transplant patients should not avoid the procedure as the benefit far outweighs the risks.
Reference:
Kaul, D.R., et al. “Donor to Recipient Transmission of Sars‐Cov‐2 by Lung Transplantation despite Negative Donor Upper Respiratory Tract Testing.” American Journal of Transplantation, 2021, doi:10.1111/ajt.16532.
