The story of a woman in Michigan who contracted COVID-19 from a lung transplant and died 60 days later has sparked concerns over whether the medical procedure is safe during the pandemic. But experts tell Yahoo Life that the incident is exceptionally rare and — out of some 39,000 organ transplants last year in the U.S. — is the first documented case of COVID-19 being passed on from a donor.
"These events are quite unusual," says Dr. David Klassen, chief medical officer of the United Network for Organ Sharing (UNOS), a nonprofit organization in charge of the U.S.'s organ transplant program. "We're monitoring [cases like this] very carefully as we go forward, and this is certainly a high priority," he adds. Klassen says that all donors are screened for COVID-19 before a transfer occurs — a process that's been in place since late April — but that most tests are done through nasal pharyngeal swab, which may have missed this case.
According to the case report about this incident, published in the American Journal of Transplantation this month, the Michigan woman became severely ill with COVID-19 symptoms three days after receiving the transplanted lung, which came from another woman, who had died in a car accident. The donor's family said she showed no signs of the virus in the days leading up to the crash and that a nasal swab taken within 48 hours came back negative.
But when the Michigan woman started showing symptoms while testing negative, the doctors decided to test the lung fluid from both her and the donor and found they were positive. Dr. Daniel Kaul, director of transplant infectious disease service at the University of Michigan, told the Washington Post that he knew something wasn't right. "I was seeing the patient, and I was very concerned that this could have come from the donor because it would be really unusual that it would be down deep in the lungs but not in the upper respiratory tract [nose and throat]."
Klassen says that a case like this highlights the need for rigorous testing, including — in the event of a lung transplant — using a specialized test to analyze "secretions that are obtained from deep inside the lungs." This test, he says, is not something all hospitals have access to and is therefore not uniformly available, which may explain why the woman received lungs that were carrying COVID-19.
Although this story may seem alarming to some, Klassen says that overall, the pandemic has done little to disrupt the U.S.'s organ donation program. Based on statistics shared with Yahoo Life from UNOS, there were 39,000 organ donations performed in 2020, a number that's on par with previous years. In total, there were 2,539 lung transplants, just 200 fewer than the year before.
That's not to say there weren't hurdles early on. "When the pandemic first hit — before there was a lot of knowledge about COVID-19 and before adequate testing was in place, transplant numbers decreased by about 50 percent," says Klassen. "Living donor transplants, which are somewhat more elective — they ceased entirely across the country for a short period of time." But a month into the pandemic, when organizations gained a better understanding of COVID-19 and how to test for it, the numbers "rebounded" and reached "the pace we expect them to be," he says.
Klassen says that with rigorous testing, these life-saving procedures can be performed even in the midst of a deadly pandemic — but that, as always, it's about weighing the different options. "I think people have to be realistic about what risks there are and they need to discuss those risks with their doctors," says Klassen. "Weigh what their risks of any given organ are and how well they might survive waiting for another opportunity that may or may not come."
He hopes that those reading about the tragic story in Michigan realize that it is unusual, and that the vast majority of transplantations that occurred last year had positive outcomes. "I think people should have confidence in the system as a whole," he says. "It's always going to be an issue of risks and benefits, but I think for the majority of patients, probably the benefits outweigh the risks. Patients and doctors need look at each offer critically, but I think transplants can move ahead safely."
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