Organ Donation

Question 1

Which organs can be donated from a patient who died and COVID was a contributing factor?

Which organs can be donated from a patient who is SARS-CoV-2 positive but with no COVID diagnosis at time of death?

What is the prophylaxis/follow up in the recipient?

Answer 1

None - donations not accepted

Donations of non-lung organs accepted (low risk). No prophylaxis, but recipients should be tested weekly for 14 days

Question 2

What testing is done pre organ transplant for HHV-8? And when was this initiated in the UK? Which organ transplant is most often affected?

Answer 2

Serology is performed pre transplant, but results not available Pre transplant

Started in 2023

Kidney transplant

Question 3

What follow up would you do for an HHV-8 negative patient transplanted with an HHV-8 positive organ?

Answer 3

PCR monthly for 3 months
PCR quarterly for next 9 months
Final serology at 18 months

Seroconversion should be detected within 3 months and disease usually occurs within 18 months

Question 4

Which organs can be donated from a patient who

a) Died due to influenza infection
b) Had influenza but did not die of flu

What would be the prophylaxis?

Answer 4

a) Lung (and bowel*) contraindicated. All other organs can be used

b) Lung can be used after thorough assessment - prophylaxis required. All other organs can be used

Prophylaxis can be used, but if so then treatment doses should be used. Can screen by PCR between days 2-10 post transplant

*Note SaBTO says can’t use bowel, flu specific guidelines say you can…

Question 5

When a patient with HBV/HDV has a liver transplant what can they receive (HBV status)?

Answer 5

Only HBV negative livers to avoid superinfection of the transplanted liver

Question 6

Prophylaxis for HBV/HDV infected patients post liver transplant

Answer 6

HBIG and NAs should be continued indefinitely

Question 7

How long should gamete donation be deferred after leaving an Ebola risk area?

Answer 7

2 years for males, 6 months for females

Question 8

When can organs from deceased donors with HIV be used?

Answer 8

In exceptional circumstances for HIV - recipients

Or in HIV + recipients (who have well controlled HIV) as long as donor is:

CD4 >200
VL <50 for 6 months prior to death
No drug resistance or failure
Genotype info available if possible