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Successful lung transplantation using an allograft from a COVID-19-recovered donor: a potential role for subgenomic RNA to guide organ utilization.

ABSTRACT: Although the risk of SARS-CoV-2 transmission through lung transplantation from acutely infected donors is high, the risks of virus transmission and long-term lung allograft outcomes are not as well described when using pulmonary organs from COVID-19-recovered donors. We describe successful lung transplantation for a COVID-19-related lung injury using lungs from a COVID-19-recovered donor who was retrospectively found to have detectable genomic SARS-CoV-2 RNA in the lung tissue by multiple highly sensitive assays. However, SARS-CoV-2 subgenomic RNA (sgRNA), a marker of viral replication, was not detectable in the donor respiratory tissues. One year after lung transplantation, the recipient has a good functional status, walking 1 mile several times per week without the need for supplemental oxygen and without any evidence of donor-derived SARS-CoV-2 transmission. Our findings highlight the limitations of current clinical laboratory diagnostic assays in detecting the persistence of SARS-CoV-2 RNA in the lung tissue. The persistence of SARS-CoV-2 RNA in the donor tissue did not appear to represent active viral replication via sgRNA testing and, most importantly, did not negatively impact the allograft outcome in the first year after lung transplantation. sgRNA is easily performed and may be a useful assay for assessing viral infectivity in organs from donors with a recent infection.

SUBMITTER: Saharia KK

PROVIDER: S-EPMC9833374 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Successful lung transplantation using an allograft from a COVID-19-recovered donor: a potential role for subgenomic RNA to guide organ utilization.

Saharia Kapil K KK Ramelli Sabrina C SC Stein Sydney R SR Roder Allison E AE Kreitman Allie A Banakis Stephanie S Chung Joon-Yong JY Burbelo Peter D PD Singh Manmeet M Reed Robert M RM Patel Vipul V Rabin Joseph J Krupnick Alexander S AS Cohen Jeffrey I JI de Wit Emmie E Ghedin Elodie E Hewitt Stephen M SM Vannella Kevin M KM Chertow Daniel S DS Grazioli Alison A

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons 20230111 1

Although the risk of SARS-CoV-2 transmission through lung transplantation from acutely infected donors is high, the risks of virus transmission and long-term lung allograft outcomes are not as well described when using pulmonary organs from COVID-19-recovered donors. We describe successful lung transplantation for a COVID-19-related lung injury using lungs from a COVID-19-recovered donor who was retrospectively found to have detectable genomic SARS-CoV-2 RNA in the lung tissue by multiple highly ...[more]

PMID: 36695611

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Project description:PurposeTo determine the extent of variability in meniscus size and anthropometric data between donors (supply) and patients (demand), to evaluate potential factors that may contribute to size discrepancies, and to determine whether the discrepancies lead to longer patient wait times.MethodsLateral and medial meniscal measurements, anthropometric data, and time to match a donor graft were extracted from a tissue supplier database. The frequency and distribution of meniscus size were analyzed. Body mass index (BMI), relative meniscus area, body mass to meniscus area index, and height to meniscus area index were compared between patient and donor pools via χ2 tests and independent samples t-test. The effect of size on time to match was analyzed using analysis of variance and post-hoc Tukey test.ResultsThe lateral meniscus patient population showed a greater frequency of larger size requirements compared to the donor population (P < .001) and the medial meniscus patient population showed a higher frequency of smaller meniscus size requirements (P < .001). The medial meniscus analysis showed significantly smaller meniscus areas (P < .001) in the patient population contributing to the observed trend of an increased body mass to meniscus area index and height to meniscus area index. The time to match a donor meniscus was affected by the patient meniscus size.ConclusionsThis analysis demonstrates variations in frequency of meniscus sizes between donor and patient populations. This variation is attributed to differences in anthropometric data between patient and donor populations. This work identifies a mismatch between demand and supply for certain patient sizes contributing to longer times to match.Clinical relevanceThis work associated donor and patient mismatches with longer wait times. This can be useful for patient counseling as well as provide a framework to determine whether there are solutions within the current meniscus donor pool that can be used to meet this clinical need.

Dataset Information

Successful lung transplantation using an allograft from a COVID-19-recovered donor: a potential role for subgenomic RNA to guide organ utilization.

Publications

Successful lung transplantation using an allograft from a COVID-19-recovered donor: a potential role for subgenomic RNA to guide organ utilization.

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