Islet cell transplantation: the effects of COVID-19 pandemic

Abstract

BACKGROUND: Coronavirus Disease 2019 (COVID-19) caused by SARS-CoV-2 coronavirus is a worldwide epidemic. Estimates of the infection vary by country and region, and US reports over a quarter of the total COVID-19 cases, reported worldwide. COVID-19 has made a significant impact on organ transplantation, in general, and islet cell transplantation, in particular. Islet cell transplantation has been proven a viable cell replacement strategy for treatment of patients with impaired awareness of hypoglycemia and severe hypoglycemia and is now approved as standard of care in Canada, Europe, Japan and Australia. Clinical success of an islet transplant is largely dependent on the quality of a deceased donor pancreas. Hence, careful selection and testing of potential organ donors are of critical importance. The threat of COVID-19 transmission has either significantly slowed down or completely shut down islet transplant programs in most US transplant centers. MATERIALS AND METHODS: Literature regarding COVID-19 infection rates and mitigation strategies, National Institutes of Health, American Society of Transplantation and UNOS (United Network for Organ Sharing) recommendations regarding donor organ testing for SARS-CoV-2 and resource allocation were reviewed. CONCLUSIONS: Impact of local COVID-19 transmission and changing epidemiology of the disease, availability of resources that include protective equipment, donor procurement teams and adequate donor testing, impact of immunosuppression regiments on COVID-19 infection, as well as local regulations, are issues that should be critically assessed prior to reopening islet transplant programs.

Keywords

• covid-19
• donor organ testing
• islet cell transplantation
• organ transplantation
• rapid diagnostic tests
• sars-cov-2 screening
• sars-cov-2 testing