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.


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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