Solid Organ Transplantation from SARS-CoV-2–infected Donor to Uninfected Recipients: First in the United Arab Emirates and the Neighboring Region

Abstract

The lifesaving practice of organ donation and transplantation has been deeply impacted by the COVID-19 pandemic. Up until January 2022, donors were screened out of the donor pool in the UAE if they tested positive for SARS-COV-2. We report a case of a COVID-19 infected donor whose organs were transplanted to 3 uninfected recipients (2 kidneys, 1 liver). A national guideline was created to permit a change in practice after the engagement and endorsement of relevant stakeholders. Recipients were informed of Donor’s COVID status and consented. The Donor was a 35-year-old previously healthy male who was hospitalized due to a spontaneous intracerebral bleed of unclear etiology and met brain death criteria. SARS-COV-2 PCR testing was obtained on admission and remained persistently positive beyond day 14 of admission. The donor was otherwise afebrile and had normal inflammatory markers with no evidence of an infectious pulmonary process on CT scan. The donor did not receive any COVID therapies. The donor had received 3 doses of the Sinopharm vaccine, the last dose being 3 months prior to admission. Organ retrieval occurred on day 24 of COVID-19 PCR positivity to three uninfected recipients in two different transplant centers in the UAE. Transplanting solid organs from non-lung COVID positive donors can effectively maintain an expanded donor pool during the pandemic.