Beatriz Domínguez-Gil1, Mario Fernández-Ruiz2, Domingo Hernández3, Marta Crespo4, Jordi Colmenero5, Elisabeth Coll1, Juan José Rubio6. 1. Organización Nacional de Trasplantes, Madrid, Spain. 2. Unit of Infectious Diseases, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain. 3. Nephrology Service, Hospital Regional Universitario de Málaga, Málaga, Spain. 4. Nephrology Service, Hospital del Mar, Barcelona, Spain. 5. Liver Transplant Unit, Clinic Hospital, Barcelona, Spain. 6. Intensive Care Unit, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
Abstract
BACKGROUND: Spain has been amongst the countries most affected by the COVID-19 pandemic, which has posed significant challenges to the donation and transplantation program. Despite a dramatic decrease of donation and transplantation activities during the critical early weeks of the outbreak, the program has recovered and is learning to cope with COVID-19. METHODS: We describe the 4 pillars upon which the Spanish donation and transplantation program has been rebuilt. RESULTS: (1) Standards have been developed and progressively updated for the evaluation and selection of potential donors and recipients with regards to SARS-CoV-2 infection. (2) Spain has been actively generating evidence to assess the validity of our standards and to understand the natural history of the infection in transplant recipients. No case of donor-derived COVID-19 has been reported to date. COVID-19 has been more frequent and has had a more aggressive course in recipients of solid organ transplants than in the general population, but this seems largely explained by the demographics and comorbidity of transplant patients. (3) As a result of this evidence and experience, recommendations have been issued for the management of COVID-19 in solid organ transplant recipients and candidates on the waiting list. (4) Finally, concrete guidance has been issued for centers to manage the donation and transplantation programs in relation to a dynamic and heterogeneous epidemiologic scenario. CONCLUSIONS: The Spanish experience confronting the impact of COVID-19 upon donation and transplantation may help serve the needs of a broader community in other countries.
BACKGROUND: Spain has been amongst the countries most affected by the COVID-19 pandemic, which has posed significant challenges to the donation and transplantation program. Despite a dramatic decrease of donation and transplantation activities during the critical early weeks of the outbreak, the program has recovered and is learning to cope with COVID-19. METHODS: We describe the 4 pillars upon which the Spanish donation and transplantation program has been rebuilt. RESULTS: (1) Standards have been developed and progressively updated for the evaluation and selection of potential donors and recipients with regards to SARS-CoV-2 infection. (2) Spain has been actively generating evidence to assess the validity of our standards and to understand the natural history of the infection in transplant recipients. No case of donor-derived COVID-19 has been reported to date. COVID-19 has been more frequent and has had a more aggressive course in recipients of solid organ transplants than in the general population, but this seems largely explained by the demographics and comorbidity of transplant patients. (3) As a result of this evidence and experience, recommendations have been issued for the management of COVID-19 in solid organ transplant recipients and candidates on the waiting list. (4) Finally, concrete guidance has been issued for centers to manage the donation and transplantation programs in relation to a dynamic and heterogeneous epidemiologic scenario. CONCLUSIONS: The Spanish experience confronting the impact of COVID-19 upon donation and transplantation may help serve the needs of a broader community in other countries.
Authors: Florentino Villanego; Auxiliadora Mazuecos; Isabel M Pérez-Flores; Francesc Moreso; Amado Andrés; Carlos Jiménez-Martín; María Molina; Cristina Canal; Luis A Sánchez-Cámara; Sofía Zárraga; María Del Carmen Ruiz-Fuentes; María José Aladrén; Edoardo Melilli; Verónica López; Emilio Sánchez-Álvarez; Marta Crespo; Julio Pascual Journal: Am J Transplant Date: 2021-04-12 Impact factor: 8.086
Authors: Gabriel Putzer; Lukas Gasteiger; Simon Mathis; Arjan van Enckevort; Tobias Hell; Thomas Resch; Stefan Schneeberger; Judith Martini Journal: Transplantation Date: 2022-04-11 Impact factor: 5.385
Authors: Renato Romagnoli; Salvatore Gruttadauria; Giuseppe Tisone; Giuseppe Maria Ettorre; Luciano De Carlis; Silvia Martini; Francesco Tandoi; Silvia Trapani; Margherita Saracco; Angelo Luca; Tommaso Maria Manzia; Ubaldo Visco Comandini; Riccardo De Carlis; Valeria Ghisetti; Rossana Cavallo; Massimo Cardillo; Paolo Antonio Grossi Journal: Am J Transplant Date: 2021-09-13 Impact factor: 8.086