Hearts from donors who had COVID are safe for transplant

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By Cara Murez

Health Day Reporter

MONDAY, Oct. 31, 2022 (HealthDay News) — A person with heart failure in urgent need of a new heart may have faced delays in obtaining a new heart during the pandemic, when potential donors tested positive for COVID-19.

As some centers began accepting these hearts for transplant anyway, data from a new study shows hearts from COVID-19 positive donors may be just as safe to be transplanted as those from someone without the virus.

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

The study, to be presented at the American Heart Association’s annual meeting November 5-7 in Chicago, looked at the cases of transplant recipients in the first 30 days after their surgery using the United Network for Organ Sharing database.

The database contained information on all adult heart transplants in the United States from February 2021 to March 2022. Out of a total of 3,289 heart donations, 84 were from COVID-positive donors.

The researchers found that both groups of donor organ recipients had similar in-hospital and 30-day post-transplant death rates. They also had similar rates of complications. These included pulmonary complications or organ rejection.

For patients with hearts from people not infected with COVID-19, the average hospital stay was 17 days. It’s been 15 days for those who received a heart from a COVID-positive donor.

Organ rejection occurred in 2.4% of recipients from COVID-19 positive donors. It happened in 1% of the others.

About 97% of those who received hearts from donors without the virus survived, as did 96.1% of those who received hearts from people with the virus.

None of the four patients who died after receiving a heart from a COVID-positive donor died of respiratory disease or infection, according to the study.

The researchers expressed surprise at the results.

“Specifically, we thought that death from respiratory or pulmonary causes would be an issue in recipients receiving donor hearts with COVID-19,” Kim said in a Heart Society press release. “However, we did not find any such differences, and indeed this study provides early evidence that COVID-19 positive donor hearts may be as safe for heart transplantation as non-COVID-19 hearts.”

The American Heart Association/American College of Cardiology/Heart Failure Society of America 2022 heart failure management guidelines recommend heart transplantation for people who develop advanced (stage D) heart failure.

When they reach stage D, sufferers suffer from shortness of breath, fatigue, and swelling that interferes with daily life. This can lead to repeated hospitalizations.

In the United States, 3,658 people received hearts in 2020, up from 1,676 in 1988, according to the American Heart Association’s Heart Disease and Stroke Statistics-2022.

More than 3,400 Americans are currently waiting for a heart.

“Despite the increased need for this surgery, there remains a shortage of available donor organs for people who need a transplant. The COVID-19 pandemic has exacerbated the situation with an increased rate of donors testing positive for COVID-19, generally indicating the donors unsuitable for transplantation,” Kim said. “However, several academic centers in the started using COVID-19 positive donor hearts for heart transplants in recent months and have reported good results.”

However, the study size was small. Longer-term studies are needed to assess how patients who receive hearts from COVID-19-positive donors fare beyond 30 days after surgery, the researchers said.

“These results provide evidence that 30 days post-transplant outcomes were similar in patients who received COVID-19 positive donor hearts, so the potential risks appear to be lower than expected,” said Dr. Eldrin Lewis, who has advanced heart failure and heart transplant specialist, Dr. medical Simon H. Stertzer, Professor of Cardiovascular Medicine and Chair of the Department of Cardiovascular Medicine at Stanford University in California.

“This, in turn, can help address the shortage of donor hearts for transplant and reduce wait times, as people with progressive heart failure often get sicker while waiting for a donor heart to become available,” Lewis said in the press release.

Findings presented at medical congresses are considered preliminary until published in a peer-reviewed journal.

More information

The US National Heart, Lung and Blood Institute has more on heart failure.

SOURCE: American Heart Association, press release, October 31, 2022



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