16 Mar 2020: Coronavirus Update for Transplant
UNOS nor AOPO have put out any updates since last week
Here are the status updates for today:
- OPO’s continue to operate under the normal guidelines for donors and allocation. However, with hospital acquired disease now affecting healthcare workers some OPO’s have shifted to a system of more remote evaluations of donors through EMR’s. Tissue agencies have added additional screening questions/criteria to screening forms.
- Transplant centers are beginning to restrict transplants. What we have learned so far from the centers we have spoken too is there is concern for viral infection spread; especially in the post transplant immune suppressed patients. A case this weekend of a surgeon in a hospital testing positive after being in the ICU, OR and ER of the hospital opened the eyes to exposure potential. This is so new, we can’t even think of all the potential issues. The greater concerns are growing from the limited ICU beds and ventilators as well as the other resources of the hospitals.
- Everyone expects, based on international reports, that there will be an “explosion” of patients requiring ventilator support and ICU care. Heart, kidney, pancreas, intestine recipients are seen as being able to wait, unless there is a critical situation, options like VAD’s and dialysis exist although there is growing concern about infection rates in dialysis clinics. Lungs and livers have less options for mechanical support alternatives and are continuing at this point. These changes are leading to longer organ donor times as OPO’s are exhausting the match runs for organs and not locating recipients.
The major frustration is that there is no national guidance or even dialogue, there is limited experience that has been published and because transplant is not classified by hospitals as an “elective” procedure, decisions about how to proceed are left to the departments and not necessarily addressed in emergency plans. We expect this week will bring massive change for many programs. One of the transplant pulmonologist shared her frustration this weekend of not having a means for communicating nationally with partners in a “non-judgmental” forum. A place where people could simply brainstorm, seek guidance and opinions and share experiences. She shared the tremendous value that would exist talking with colleagues for opinions, to know what they were doing or what their experiences were at this point.