COMMENT:
The COVID-19 pandemic poses a variety of challenges for transplant
programs. Balancing the risk of waitlist mortality, the safety of the
transplant team staff, and the unknown outcome of an immunosuppressed
recipient contracting COVID-19 is difficult.
To our knowledge, a case of a patient awaiting heart transplant who
contracts COVID-19, survives, and then undergoes successful OHT has not
been reported in the literature. This case is of interest to
demonstrate that OHT is still feasible in a recipient who has negative
COVID-19 PCR prior to transplant in the setting of a prior positive
test.
As the pandemic evolves, with the inevitable increase in numbers of
COVID-19 patients in the population, transplant centers will need to
explore the implications of COVID-19 positivity in the pre-transplant
and immediate post-transplant period in order to continue to
successfully provide heart transplant to our waitlist population.
This is the first patient described in the literature to survive
COVID-19 and then undergo successful OHT. Our patient has no obvious
sequela of COVID-19 infection and has been COVID negative since time of
transplant.
As the global pandemic continues, this case demonstrates the safety and
feasibility of continuing to provide OHT to patients who are survivors
of COVID-19.
Further study is warranted to elucidate any impact of prior COVID-19
infection on immunosuppressive regimen or possible long standing
pulmonary complications post-transplant.