Red flag raised for donor hearts from COVID-deceased

Essential heart transplants might need an extra level of screening to check whether their donor died while positive for COVID-19, say US researchers.

The research published in the Journal of the American College of Cardiology investigated post-transplant outcomes associated with a donor’s COVID-19 status.

It found a higher likelihood of recipient mortality after six and 12 months among those who received a heart from an active COVID-19 case, as opposed to those who had recently recovered or tested negative for the SARS-CoV-2 virus.

From 27,000 heart donors in the US Network for Organ Sharing, the study identified transplant organs from donors who were either active COVID-19 cases, recently recovered or negative for COVID-19 testing.

At six months, COVID-positive hearts had a 13.8% mortality risk (as opposed to 7% in non-COVID transplants) and 23.2% at one year (versus 9.2%).

Risk was similar between recently recovered and negative cases at the same intervals.

While the data is preliminary, the researchers say the findings should flag concerns for health services when identifying suitable hearts for transplantation surgery.

“These early trends should be concerning enough such that heart transplantation centres need to thoroughly evaluate and continue to weigh the risks and benefits of using hearts from active COVID-19 donors,” said Dr Shivank Madan, a cardiologist at the Center for Advanced Cardiac Therapy at the Montefiore Medical Center and Albert Einstein College of Medicine, USA.

The research contrasts with findings from the American Heart Association in 2022, which in a smaller sample of 84 COVID-positive donor hearts had comparable short-term outcomes to negative ones.