A lung transplant procedure last fall in Michigan resulted in the death of the patient and the illness of an affected surgeon from COVID-19, after both the donor and recipient initially tested negative. Doctors say this is the first documented case of a transplant recipient contracting the virus from a donor.
The lung donor, according to doctors, was a Midwestern woman who suffered serious brain damage in a car accident in November. She quickly developed into “brain dead,” said the report recently published, and she was tested for COVID-19 before her organs were donated.
Her family said she showed no signs of COVID-19 symptoms and no travel history in the days before the accident.
“We absolutely wouldn’t have used the lungs if we had a positive Covid test,” Dr. Daniel Kaul, who co-authored the report in the American Journal of Transplantation on the case, and the director of the Mighigan Mediciden infectious disease transplant service told NBC News.
The recipient had chronic obstructive pulmonary disease and was tested for COVID-19 at University Hospital in Ann Arbor before transplantation.
“We’ve done all the screening that we normally do and can do,” said Kaul.
Three days after the procedure, the recipient developed a fever, her blood pressure dropped, and it became difficult for her to breathe. Pictures of her new lung showed signs of infection.
Test samples from her new lungs were positive for COVID-19.
Four days after the procedure, the surgeon who handled the donor’s lungs tested positive for COVID-19.
In search of answers, doctors returned to samples taken from the donor. A test performed 48 hours after the lungs were obtained was negative for COVID-19. However, they were able to test a sample taken deep into the donor’s lungs. That sample came back positive.
Genetic testing showed that the surgeon and the recipient were infected by the donor.
The transplant recipient’s condition deteriorated and, 61 days after the lung transplant procedure, she died.
The surgeon has recovered.
While doctors involved in the study of this incident say this is the first confirmed case of COVID-19 transmission from an organ transplant, other cases have been suspected.
The CDC recently looked at eight incidents from the start of the pandemic, but they found that community or health care exposure was the most likely source of the infection.
The doctors who wrote the report, from the University of Michigan, are calling for caution and more testing during transplants.
“Transplant centers and organ procurement organizations should conduct SARS-CoV-2 testing on lower respiratory tract samples from potential lung donors, and consider improved personal protective equipment for health professionals involved in lung procurement and transplantation,” the report authors said.
They also noted that because both donor and recipient had tested negative for COVID-19, according to an accepted protocol, the health professionals 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 transplant, even with negative COVID-19 tests.
No other organs from the donor were used.