https://pubmed.ncbi.nlm.nih.gov/36195971/ liver transplant

Pediatr Transplant. 2022 Oct 4;e14407.

doi: 10.1111/petr.14407. Online ahead of print.
A new chapter in an evolving pandemic: Successful pediatric liver transplantation with SARS-CoV-2+ donors

Matthew Benjamin Goss 1, Daniel Hao Bin Leung 2, Stephanie Marie Pouch 3, Flor M Munoz 4, Elizabeth Andrea Moulton 4, Tyler Malcolm Mccann Lambing 5, Sarah Koohmaraie 6, Nicolas Fernando Moreno 1, Christine A O'Mahony 7, John A Goss 7, Nhu Thao Nguyen Galván 7
Affiliations expand
PMID: 36195971

DOI: 10.1111/petr.14407
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Abstract

Background: Amid a viral pandemic with poorly understood transmissibility and pathogenicity in the pediatric patient, we report the first pediatric liver transplants utilizing allografts from SARS-CoV-2+ donors.

Methods: We describe the outcomes of two pediatric liver transplant recipients who received organs from SARS-CoV-2 nucleic acid test-positive (NAT+) donors. Data were obtained through the respective electronic medical record system and UNet DonorNet platform.

Results: The first donor was a 3-year-old boy succumbing to head trauma. One of four nasopharyngeal (NP) swabs and 1 of 3 bronchoalveolar lavage (BAL) NAT tests demonstrated SARS-CoV-2 infection before organ procurement. The second donor was a 16-month-old boy with cardiopulmonary arrest of unknown etiology. Three NAT tests (2 NP swab/1 BAL) prior to procurement failed to detect SARS-CoV-2. The diagnosis was made when the medical examiner repeated 2 NP swab NATs and an archive plasma NAT, all positive for SARS-CoV-2. Both 2-year-old recipients continue to do well 8 months post-transplant, with excellent graft function and no evidence of SARS-CoV-2 transmission.

Conclusions: This is the first report to describe successful pediatric liver transplantation from SARS-CoV-2+ donors. These data reinforce the adult transplant experience and support the judicious use of SARS-CoV-2+ donors for liver transplantation in children. With SARS-CoV-2 becoming endemic, the concern for donor-derived viral transmission must now be weighed against the realized benefit of life-saving transplantation in the pediatric population as we continue to work toward donor pool maximization.