Patterns And Outcomes Of Covid Positive Donor Utilization For Heart Transplant

Background The outcomes following COVID positive donor utilization for heart transplant are unknown. Methods UNOS database was analyzed for heart transplants performed after the declaration of COVID pandemic on 11th March 2020 until 31st December 2021. The cohort was divided into two groups based on donor COVID antigen and NAAT results. Result Since the onset of pandemic, there were 6855 heart transplants reported. COVID antigen or NAAT results were available in 5529 donors at the time of donation, of which 38 (0.7%) were positive. COVID positive donors (CPD) were accepted for older recipients (age 54 vs 48, p=0.04). Listing status 1 and 2 were similar in both groups (9% vs 5% and 24% vs 23% respectively). Durable mechanical support (LVAD, RVAD, TAH) were similar in both groups pre-transplant (31% vs 33%, p=0.3). There was no difference in days on waitlist (183 vs 176 days, p=0.9). Both groups had similar travel distance (261 vs 239 nautical miles, p=0.4) and ischemic time (3.6 vs 3.5 hours, p= 0.8). Simultaneous renal transplant rates were similar (10% vs 9%, p=0.8). CPD utilization increased with time (figure 1A) and was uniform across most UNOS regions (figure 1B) Post-transplant, there was no difference in length of stay (24 days in both groups) and acute rejection episode prior to discharge (4% vs 8%, p=0.6) or within one year (3% vs 4%). There were no deaths reported in the CPD group during a mean 72 days of follow up (range 0-365 days) (figure 2). Known hospitalization for rejection management were similar (3% vs 4%) post-transplant. Conclusion Active COVID infection in donors did not affect survival or rejection rates in the short-term post-heart transplant The outcomes following COVID positive donor utilization for heart transplant are unknown. UNOS database was analyzed for heart transplants performed after the declaration of COVID pandemic on 11th March 2020 until 31st December 2021. The cohort was divided into two groups based on donor COVID antigen and NAAT results. Since the onset of pandemic, there were 6855 heart transplants reported. COVID antigen or NAAT results were available in 5529 donors at the time of donation, of which 38 (0.7%) were positive. COVID positive donors (CPD) were accepted for older recipients (age 54 vs 48, p=0.04). Listing status 1 and 2 were similar in both groups (9% vs 5% and 24% vs 23% respectively). Durable mechanical support (LVAD, RVAD, TAH) were similar in both groups pre-transplant (31% vs 33%, p=0.3). There was no difference in days on waitlist (183 vs 176 days, p=0.9). Both groups had similar travel distance (261 vs 239 nautical miles, p=0.4) and ischemic time (3.6 vs 3.5 hours, p= 0.8). Simultaneous renal transplant rates were similar (10% vs 9%, p=0.8). CPD utilization increased with time (figure 1A) and was uniform across most UNOS regions (figure 1B) Post-transplant, there was no difference in length of stay (24 days in both groups) and acute rejection episode prior to discharge (4% vs 8%, p=0.6) or within one year (3% vs 4%). There were no deaths reported in the CPD group during a mean 72 days of follow up (range 0-365 days) (figure 2). Known hospitalization for rejection management were similar (3% vs 4%) post-transplant. Active COVID infection in donors did not affect survival or rejection rates in the short-term post-heart transplant