Pre-transplant testing: A cautionary tale

Reviewed by Hannah Imlay, MD, MS, University of Utah

This case report describes transmission of SARS-CoV-2 from a lung donor unrecognized to have SARS-CoV-2 to both a transplant recipient and a surgeon involved in the procedure. Although nasopharyngeal testing was negative prior to transplant, a donor lower respiratory tract specimen was retrospectively found to be positive. SARS-CoV-2 testing of lower respiratory tract is recommended by national and international transplant societies if safe and feasible, but there are logistical constraints. This case exemplifies the importance of pre-transplant lower tract SARS-CoV-2 testing for lung donors and also highlights the utility of full PPE in the operating room when handling respiratory secretions despite previous negative testing.

References:

Kaul DR, Valesano AL, Petrie JG, Sagana R, Lyu D, Lin J, Stoneman E, Smith LM, Lephart P, Lauring AS. Donor to Recipient Transmission Of SARS-CoV-2 By Lung Transplantation Despite Negative Donor Upper Respiratory Tract Testing. Am J Transplant. 2021 Feb 10. doi: 10.1111/ajt.16532. Epub ahead of print. PMID: 33565705.

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