Utilization of deceased donors during a pandemic: An argument against using SARS‐CoV‐2 positive donors

Shah, Malay B.; Lynch, Raymond J.; El‐Haddad, Hanine; Doby, Brianna; Brockmeier, Diane; Goldberg, David S.

SARS‐CoV‐2 has rapidly become an unprecedented pandemic that has impacted society, disrupted hospital functions, strained healthcare resources and impacted the lives of transplant professionals. Despite this, organ failure and the need for transplantation continues throughout the United States. Considering the perpetual scarcity of deceased donor organs, Kates et al present a viewpoint that advocates for the utilization of COVID‐19 positive donors in selected cases. We present a review of the current literature that details the potential negative consequences of COVID‐19 positive donors. The factors we consider include: 1) the risk of blood transmission SARS‐CoV‐2, 2) involvement of donor organs, 3) lack of effective therapies, 4) exposure of healthcare and recovery teams, 5) disease transmission and propagation, and 6) hospital resource utilization. While we acknowledge that transplantation fulfills the mission of saving lives, it is imperative to consider the consequences not only to our recipients, but also to the community and to healthcare workers, particularly in the absence of effective preventative or curative therapies. For these reasons, we believe the evidence and risks show that COVID‐19 infection should continue to remain a contraindication for donation, as has been the initial response of donation and transplantation societies.