Tuesday, November 30

Transplants organs from previously coronary heart disease

ORGAN DONOR: The late “Dawson Creek” screenwriter Heidi Ferrer (50) was so run down by long-term covid-19 that she committed suicide this summer. Her husband responds that her organs were used in transplants.

In the United States, the debate is raging over whether it is safe to use the organs of covid-19 sufferers. Norwegian patients have also received organs from previously coronary patients.

This is confirmed by Professor Pål-Dag Line, head of the Department of Transplant Medicine at Oslo University Hospital (OUS).

– Transplants have been performed in Norway with organs from patients who once had covid, he says to VG.

Rikshospitalet corona tests all organ donors and recipients. The hospital does not disclose how many people have received organs from previously infected covids, for privacy reasons.

– It is not relevant to use a donor who has an active covid. It is also not relevant to transplant a patient who has ongoing covid because the risk of serious complications increases, Line states.

“Dawson’s Creek” creator died

The use of organs from former coronary heart disease has sparked debate in the United States. In early November wrote The New York Times about the late screenwriter Heidi Ferrer (1970–2021) who committed suicide after struggling with the long-term effects of covid-19.

Ferrer, who was best known for the TV series “Dawson’s Creek”, had registered as an organ donor. After her death, therefore, the organs were used for transplants even though this was against her husband’s will.

SOCIAL ACTIVIST: The photo shows the late screenwriter Heidi Ferrer during a demonstration against guns in Los Angeles in 2018.

Nick Guthe feared that his wife’s organs were not safe enough and instead wanted to donate her body for research. He has in interviews told how the late injuries after long-term covid eroded his wife physically and mentally.

The hospital must still have thought that she was a suitable organ donor. According to Guthe, two male patients in California got her kidneys. No suitable match was found for the other organs.

“I thought the agencies would kill the recipients,” he said in an interview with The New York Times.

– Heidi was a very generous person, but she would not have wanted this. We need to put in place guidelines for what is safe and what is not.

From his wife’s previous blog Girl to Mom and his own Instagram and Twitter account, Guthe shares the experience of long-covid.

In the United States, it is especially the use of immunosuppressive drugs in long-term covid that creates controversy. Some doctors fear that the medication will camouflage reactions or disease that means that organs should not really be transplanted.

Researchers in Germany who performed autopsies on 27 patients who died of covid, found the virus in the kidney and heart tissue in over 60 percent of the deceased. The researchers also found the infection in lung, liver and brain tissue.

In the United States, donors are routinely tested for coronavirus before the organs are removed. The organs are considered safe if the test is negative, but there is no documented or determined time limit for when the organs can be transplanted safely.

Most people affected by long-term covid do not test positive for covid-19, but researchers fear that the virus may still be present in the body, and may be hidden in organs that are donated and transplanted.

“The risk is that surgeons may covid the patient with the organ,” Dr. Zijian Chen, medical director at the Mount Sinai Health System Corona Center, told The New York Times.

– It is a difficult ethical question.

Patients who receive transplanted organs are required to take medicines that suppress the immune system. This is to prevent rejection of the organs.

– If they get covid, they will be susceptible to infections and poor healing. I think ethically you have to tell the patient that the risk is very real, says Chen.

Must be vaccinated to get organ

Unlike in Norway, the USA has a number of transplant programs with different guidelines. In the states of Colorado and Washington patients on the waiting list for organ donation are required to be covid-19 vaccinated. Without a vaccine, they are removed from the list. Such requirements do not exist in Norway.

– The USA has completely different numbers and larger transplant queues than in Norway. Our situation is many times better, both in terms of the covid situation and the prospect of patients on the waiting list, says Professor Dr.med. Pål-Dag Line.

– So there is no reason to fear?

– No, what is dangerous about the covid pandemic and the RS wave is that both seize quite large resources over concentrated periods of time. Our total capacity is being challenged. It is in principle dangerous, but in Norway they took action in the whole of society early enough.

REDUCED: Professor Pål-Dag Line, head of department at the Department of Transplant Medicine at Oslo University Hospital, believes there is no reason for concern for Norwegian organ recipients.

At the start of the pandemic, some transplants with live donors, such as when a family member donates a kidney, had to be postponed. But conditions are far worse in Sweden where the intensive care units have been under greater strain, according to Line.

– I also know from Spanish and Italian colleagues that cancer operations and transplants have been severely affected. If the intensive care unit is overloaded with pandemic patients, the chance of identifying a possible organ donor is lower.

Organ quality crucial

In Norway, it is the “organ quality” that determines whether an organ can be transplanted or not. As a general rule, those who receive organs are not told if the donor has had a corona.

– There must be complete anonymity, says Pål-Dag Line.

He emphasizes that the risk of becoming covids infected or having organs that are diseased and weakened is low:

– Our standard for what we accept is not affected by covid. If you have had covid or have long-covid, it must be assessed whether it has affected the quality of the organs. If everything indicates that the quality is good enough and there is no risk of infection, the organs will be used.

Only in special cases does the organ recipient get to know about the diseases of the deceased. This usually happens if it is about life and the organ that is free is in borderland for what is considered safe to transplant. Then in some cases it may be decided to use an organ that would not normally have been transplanted.

Inform only in special cases

– If we perceive the risk as clearly increased, we inform. There are settings where one is willing to accept greater risk. This may, for example, apply to cancer. But there has been no basis for this in connection with transplants we have done so far during the pandemic, Line emphasizes.

– It is very rare that, for example, a liver transplant is canceled, but it is important to let the recipient know about a potential risk if it is present.

Line is responsible for transplantation of the liver, lungs and pancreas.

– They would surprise me greatly if lungs from previous covid disease have been transplanted. This is because it is so common that the lungs are damaged after having corona.

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