Liver transplantation using COVID-19 positive donors may be safe option to expand access
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Key takeaways:
- Patient and allograft survival were similar between COVID-19 positive and negative donors 1 year after liver transplantation.
- Use of COVID-19 positive organs increase during peaks of COVID-19.
BOSTON — Researchers reported similar patient and allograft survival 1 year after liver transplantation between COVID-19 positive and negative donors, showing potential for expanding organ access, according to data at The Liver Meeting.
“During the peak of the COVID-19 pandemic, the volume of liver transplants decreased worldwide,” Roy X. Wang, MD, of Penn Medicine, said in a related Q&A with AASLD. “As COVID-19 became more widespread, in small studies researchers found that patients who received solid organ transplants from COVID-19 positive donors appeared to have acceptable short-term outcomes compared to patients who received transplants from COVID-19 negative donors.”
“We wanted to explore the safety of liver transplantation from COVID-19 positive donors using a large national dataset with the longest follow-up time to date.” – Roy X. Wang, MD
He continued, “We wanted to explore the safety of liver transplantation from COVID-19 positive donors using a large national dataset with the longest follow-up time to date.”
In a retrospective cohort study, Wang and colleagues used the United Network for Organ Sharing registry to identify liver transplant recipients from July 2020 to July 2022, of whom 13,096 received livers from COVID-19 negative donors and 299 from COVID-19 positive donors. Researchers used regression models to assess the correlation between donor status and patient and allograft survival.
According to results, COVID-19 positive donors were younger than COVID-19 negative donors (median age, 38 vs. 41 years; P < .001), more likely to be donors after brain death (94% vs. 88.8%; P = .005), and more likely to be in certain UNOS regions (P < .001). Demographics of recipients of COVID-19 negative or positive livers were not significantly different.
Further, after 1 year of post-transplant follow-up, Wang and colleagues reported no differences in patient survival (subHR = 1.11; 95% CI, 0.61-2) or allograft survival (subHR = 1.44; 95% CI, 0.88-2.36) between COVID-19 positive and COVID-19 negative donors.
“While we were able to show similar patient and graft survival post-transplant between COVID-19 positive and negative donors, rates of other complications were not investigated such as episodes of rejection, liver injury and hospitalizations,” Wang said in the Q&A. “Due to data limitations, we are only able to report on outcomes up to 1-year post-transplant.”
He added, “Additional investigation will be needed to continue monitoring future outcomes and identifying any differences between recipients of COVID-19 positive and negative donors.”