Consensus statement on organ donation from COVID-positive deceased donors-Indian Society of Organ Transplantation, Liver Transplant Society of India and Indian Society for Heart and Lung Transplantation

Sonal Asthana; Vivek Kute; Unmil Shah; Ravi Mohanka; Manisha Sahay; Chinnadurai R; Swati Rajagopal; Sujata Patwardhan; Narayan Prasad; Sandeep Guleria; Shyam Bansal; Arpita Roy Choudhary; Deepak S Ray; Sanjay Kolte; Sanjeev Gulati; Sandeep Seth; Sanjay K Agarwal; Jai Prakash Ojha; PP Varma; Sunil Shroff

doi:10.4103/ijot.ijot_29_22

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Year : 2022 \| Volume : 16 \| Issue : 1 \| Page : 8-16

Consensus statement on organ donation from COVID-positive deceased donors-Indian Society of Organ Transplantation, Liver Transplant Society of India and Indian Society for Heart and Lung Transplantation Sonal Asthana¹, Vivek Kute², Unmil Shah³, Ravi Mohanka⁴, Manisha Sahay⁵, Chinnadurai R⁶, Swati Rajagopal⁷, Sujata Patwardhan⁸, Narayan Prasad⁹, Sandeep Guleria¹⁰, Shyam Bansal¹¹, Arpita Roy Choudhary¹², Deepak S Ray¹³, Sanjay Kolte¹⁴, Sanjeev Gulati¹⁵, Sandeep Seth¹⁶, Sanjay K Agarwal¹⁷, Jai Prakash Ojha¹⁸, PP Varma¹⁹, Sunil Shroff²⁰ ¹ Hepatobiliary Surgery and Liver Transplantation, Aster CMI Hospital, Bengaluru, Karnataka; Liver Transplant Society of India, India ² Institute of Kidney Diseases and Research Center and Dr. H L Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad, Gujarat, India ³ KIMS Hospital, Hyderabad, Telangana, India ⁴ Liver Transplant Society of India; Department Hepatobiliary Surgery and Liver Transplantation, HN Reliance Hospital, Mumbai, Maharashtra, India ⁵ Department of Nephrology, Osmania Medical College and Osmania General Hospital, Hyderabad, Telangana, India ⁶ Department of Intensive Care, Aster RV Hospital, Bengaluru, Karnataka, India ⁷ Aster CMI Hospital, Bengaluru, Karnataka, India ⁸ Department of Urology, GSMC and KEMH, Parel, Mumbai, Maharashtra, India ⁹ Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India ¹⁰ Division of Renal Transplantation, Indraprastha Apollo Hospital, New Delhi, India ¹¹ Department of Nephrology, Medanta Hospital, Gurugram, Haryana, India ¹² Department of Nephrology, IPGMER, Kolkata, West Bengal, India ¹³ Renal Transplant Programme, Narayana Health (RTIICS), Kolkata, West Bengal; Indian Society of Organ Transplantation, India ¹⁴ Department of Urology, Government Medical College and SSH, Nagpur, Maharashtra, India ¹⁵ Fortis Hospitals, Delhi, India ¹⁶ Department of Cardiology, AIIMS, New Delhi, India ¹⁷ Department of Nephrology, AIIMS, New Delhi, India ¹⁸ Indian Society of Organ Transplantation; Apex Hospital, Varanasi, Uttar Pradesh, India ¹⁹ Department of Nephrology, Primus Hospital, New Delhi, India ²⁰ Indian Society of Organ Transplantation and Consultant, Madras Medical Mission Hospital, Chennai, Tamil Nadu, India Correspondence Address: Dr. Sunil Shroff Department of Urology, Sri Ramachandra Medical College Chennai, Tamil Nadu India Source of Support: None, Conflict of Interest: None DOI: 10.4103/ijot.ijot_29_22

COVID has drastically impacted organ donation across the world, leading to untold misery for thousands of patients who have been waiting for organs. Early rules on the use of organs from COVID positive or affected donors were stringent due to the fear of spread of disease or thrombotic complications in patients who received these organs. However much has changed in the past two years. Most of our adult population has either been infected with COVID, or has received two doses of vaccine, or both. The current variant, despite being more infective, is associated with mild disease, especially in those who have been vaccinated Our armamentarium against severe COVID has improved dramatically in the past year- we have effective vaccines, monoclonal antibodies for treatment of mild COVID in high risk patients and post exposure and antiviral prophylaxis and treatment which can substantially reduce the risk of severe COVID requiring ICU admission. The risk of transmission of COVID infection has to be balanced against the risk of patients dying with end organ disease. We will have to learn to live with COVID- this also means investigating whether organs from donors who are, or have been COVID positive can be used with acceptable risk –benefit in selected patients with end stage organ failure. This document is a summary of evidence and information regarding donor screening for SARS-CoV-2 and considerations for organ acceptance from donors with a history of COVID-19.



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