Risk assessment of organ donation and procurement during COVID-19 epidemic

Objective To explore the clinical evaluation effect of COVID-19 risk assessment scale on organ donation and procurement during the epidemic of novel coronavirus pneumonia, and to reduce the incidence of donor-derived infection and medical staff infection. Method From January 20 to February 29 in 2020, the organ procurement organization of the General Hospital of Southern Theater Command adopted the COVID-19 risk assessment scale in evaluating 8 cases of potential donors. The potential donors were classified into high risk level, low risk level and uncertain risk level by analyzing the risk levels of the donation hospitals, the clinical characteristics and the exposure history of the potential donors. The coordinators, organ evaluation and ward medical staff adopted essential protective measures. The infection of COVID-19 in the above mentioned staff was observed, and the graft function and the infection of COVID-19 in the corresponding recipients were observed. Result According to the COVID-19 risk assessment results, 1 of 8 potential donors was high risk level, 5 potential donors were low risk level and 2 potential donors were uncertain risk level. 6 donors (including 5 with low risk and 1 with uncertain risk) were evaluated and underwent organ procurement. 19 grafts including liver, kidney, pancreas and heart were harvested and successfully used for organ transplantation. During the observation period of 14 days, there was no suspected or confirmed infection of COVID-19 among all coordinators and medical staff. No graft dysfunction or acute rejection was observed during the follow-up period of 4 to 30 days. No recipient was suspected or conformed to be infected with COVID-19, and 6 of them were negative for COVID-19 nucleic acid testing after organ transplantation. Conclusion During the COVID-19 epidemic, it is safe to proceed with donor organ evaluation and procurement according to the result with the COVID-19 risk assessment scale. Low-risk donor organ donation should be carried out, uncertain risk donor organ donation should be carried out cautiously, and high-risk donors should not be donated. Key words: organ transplantation; Coronavirus; Graft