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Hearts from COVID-positive donors are safe for transplant

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Written by Kara Murez

A reporter for HealthDay

MONDAY, Oct. 31, 2022 (HealthDay News) — A person with heart failure in dire need of a new heart could face delays in getting one during the pandemic if potential donors test positive for COVID-19.

As some centers have begun accepting these hearts for transplant anyway, new research suggests that hearts from COVID-19-positive donors may be just as safe for transplant as hearts from people without the virus.

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

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

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

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

For heart patients in people who were not infected with COVID-19, the average length of hospital stay was 17 days. For those who received a heart from a COVID-positive donor, it was 15 days.

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

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 causes or infections, the study found.

The researchers expressed surprise at the results.

“In particular, we thought that death from respiratory or mild causes would be a problem among recipients of donor hearts with COVID-19,” Kim said in a heart association news release. “However, we found no such differences, and in fact this study provides the first evidence that donor hearts with COVID-19 may be as safe for heart transplantation as hearts without COVID-19.”

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

By the time they reach stage D, people experience shortness of breath, fatigue, and swelling that interferes with daily life. This can lead to re-hospitalization.

In the United States, 3,658 people had a heart attack in 2020, up from 1,676 in 1988, according to the American Heart Association’s 2022 heart disease and stroke statistics.

Currently, more than 3,400 Americans are waiting for a heart.

“Despite the increased need for this surgery, there is a continuing shortage of available donor organs for people in need of transplants. The COVID-19 pandemic has worsened the situation with an increase in the number of donors testing positive for COVID-19, making donors generally ineligible for transplants,” Kim said. “However, in recent months, several academic centers have begun using hearts from donors with COVID-19 for heart transplants and have reported good results.”

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

“These findings suggest that outcomes were similar 30 days after transplant in patients who received donor hearts with COVID-19, so the potential risks appear to be lower than expected,” said Dr. Aldrin Lewis, a heart failure patient. in the development stage. and heart transplant specialist Simon H. Sterzer, MD, professor of cardiovascular medicine and chairman of the Division of Cardiovascular Medicine at Stanford University in California.

“In turn, this could help address the shortage of donor hearts for transplant and reduce wait times, as people often become sicker as heart failure progresses while waiting for a donor heart to become available,” Lewis said in a release.

Results presented at medical meetings are considered preliminary to publication in a peer-reviewed journal.

Additional information

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

SOURCE: American Heart Association News Release, October 31, 2022

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