Clinical Practice Guideline for Solid Organ Donation and Transplantation During the COVID-19 Pandemic

Matthew J. Weiss, MD; Laura Hornby, MSc; Farid Foroutan, PhD; Sara Belga, MD; Simon Bernier; Mamatha Bhat, MD; C. Arianne Buchan, MD; Michael Gagnon, MD; Gillian Hardman, MBBS, FRCSed(C-Th); Maria Ibrahim, MD; Cindy Luo, PharmD; Me-Linh Luong, MD; Rahul Mainra, MD, FRCPC; Alex R. Manara, MD; Ruth Sapir-Pichhadze, MD; Sarah Shalhoub, MD; Tina Shaver, RN, BN; Jeffrey M. Singh, MD; Sujitha Srinathan; Ian Thomas, MD; Lindsay C. Wilson, MHA; T. Murray Wilson, MBA; Alissa Wright, MD; Allison Mah, MD

doi:10.1097/TXD.0000000000001199

Transplantation Direct (Oct 2021)

Clinical Practice Guideline for Solid Organ Donation and Transplantation During the COVID-19 Pandemic

Matthew J. Weiss, MD,
Laura Hornby, MSc,
Farid Foroutan, PhD,
Sara Belga, MD,
Simon Bernier,
Mamatha Bhat, MD,
C. Arianne Buchan, MD,
Michael Gagnon, MD,
Gillian Hardman, MBBS, FRCSed(C-Th),
Maria Ibrahim, MD,
Cindy Luo, PharmD,
Me-Linh Luong, MD,
Rahul Mainra, MD, FRCPC,
Alex R. Manara, MD,
Ruth Sapir-Pichhadze, MD,
Sarah Shalhoub, MD,
Tina Shaver, RN, BN,
Jeffrey M. Singh, MD,
Sujitha Srinathan,
Ian Thomas, MD,
Lindsay C. Wilson, MHA,
T. Murray Wilson, MBA,
Alissa Wright, MD,
Allison Mah, MD

Affiliations

Matthew J. Weiss, MD: 1 Transplant Québec, Montréal, QC, Canada.
Laura Hornby, MSc: 3 Canadian Donation and Transplantation Research Program (CDTRP), Ottawa, ON, Canada
Farid Foroutan, PhD: 5 Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Sara Belga, MD: 7 Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Simon Bernier: 8 Faculty of Medicine, Université Laval, QC, Canada.
Mamatha Bhat, MD: 9 Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
C. Arianne Buchan, MD: 11 Division of Infectious Diseases, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Michael Gagnon, MD: 12 Division of Nephrology and Multi-Organ Transplant Program, Department of Medicine, McGill University, Montreal, QC, Canada.
Gillian Hardman, MBBS, FRCSed(C-Th): 13 National Health Service Blood and Transplant, Bristol, United Kingdom.
Maria Ibrahim, MD: 13 National Health Service Blood and Transplant, Bristol, United Kingdom.
Cindy Luo, PharmD: 15 Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.
Me-Linh Luong, MD: 16 Department of Microbiology, Infectiology and Immunology, Université de Montréal, Montréal, QC, Canada.
Rahul Mainra, MD, FRCPC: 17 Division of Nephrology, University of Saskatchewan, Saskatoon, SK, Canada.
Alex R. Manara, MD: 13 National Health Service Blood and Transplant, Bristol, United Kingdom.
Ruth Sapir-Pichhadze, MD: 12 Division of Nephrology and Multi-Organ Transplant Program, Department of Medicine, McGill University, Montreal, QC, Canada.
Sarah Shalhoub, MD: 21 Division of Infectious Diseases, Department of Medicine, Western University, London, ON, Canada.
Tina Shaver, RN, BN: 22 Southern Alberta Organ and Tissue Donation Program, Calgary, AB, Canada.
Jeffrey M. Singh, MD: 23 Department of Medicine, University of Toronto, Toronto, Ontario, ON, Canada.
Sujitha Srinathan: 9 Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
Ian Thomas, MD: 13 National Health Service Blood and Transplant, Bristol, United Kingdom.
Lindsay C. Wilson, MHA: 4 System Development – Organ and Tissue Donation and Transplantation, Canadian Blood Services, Ottawa, ON, Canada.
T. Murray Wilson, MBA: 25 Transplant Research Foundation of British Columbia, Vancouver, BC, Canada.
Alissa Wright, MD: 28 Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Allison Mah, MD: 28 Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.

DOI: https://doi.org/10.1097/TXD.0000000000001199
Journal volume & issue: Vol. 7, no. 10
p. e755

Abstract

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Background. The coronavirus 2019 (COVID-19) pandemic has disrupted health systems worldwide, including solid organ donation and transplantation programs. Guidance on how best to screen patients who are potential organ donors to minimize the risks of COVID-19 as well as how best to manage immunosuppression and reduce the risk of COVID-19 and manage infection in solid organ transplant recipients (SOTr) is needed. Methods. Iterative literature searches were conducted, the last being January 2021, by a team of 3 information specialists. Stakeholders representing key groups undertook the systematic reviews and generation of recommendations using a rapid response approach that respected the Appraisal of Guidelines for Research and Evaluation II and Grading of Recommendations, Assessment, Development and Evaluations frameworks. Results. The systematic reviews addressed multiple questions of interest. In this guidance document, we make 4 strong recommendations, 7 weak recommendations, 3 good practice statements, and 3 statements of “no recommendation.” Conclusions. SOTr and patients on the waitlist are populations of interest in the COVID-19 pandemic. Currently, there is a paucity of high-quality evidence to guide decisions around deceased donation assessments and the management of SOTr and waitlist patients. Inclusion of these populations in clinical trials of therapeutic interventions, including vaccine candidates, is essential to guide best practices.

Published in Transplantation Direct

ISSN: 2373-8731 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://journals.lww.com/transplantationdirect/Pages/default.aspx

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