A woman with chronic obstructive lung disease at University Hospital in Ann Arbor Michigan desperately needed a lung transplant in order to live. Another woman in the Upper Midwest, died after suffering a severe brain injury in a car accident. The donor’s lungs were flown to Ann Arbor.
Kaiser Health News reported that the difficult double lung transplant was a success. Three days after the operation, however, the recipient spiked a fever; her blood pressure fell and her breathing became labored. Imaging showed signs of lung infection. She developed septic shock and heart function problems. Doctors decided to test for COVID-19. Samples from her new lungs came back positive.
Prior to the operation the donor’s body had been tested for COVID-19 from a nose swab sampling and tested negative. Test samples were not taken from the donor’s lower respiratory tract.
Four days after the transplant, the surgeon who handled the donor lungs and performed the surgery tested positive as well. Genetic screening revealed that the transplant recipient and the surgeon had been infected by the donor. Ten other members of the transplant team tested negative for the virus. The surgeon has since recovered.
The transplant recipient deteriorated rapidly, developing multi-system organ failure. Doctors tried known treatments for Covid-19, including Remdesivir, a newly approved drug, and convalescent blood plasma from people previously infected with the disease. Eventually, she was placed on the last-resort option of extracorporeal membrane oxygenation. Nothing helped. Life support was withdrawn, and she died 61 days after the transplant.
Before this tragic incident, it was not clear whether the virus could be transmitted through solid organ transplants, though it’s well documented with other respiratory viruses. Organ donors have been tested routinely for COVID-19 during the pandemic, though it’s not required by the Organ Procurement and Transplantation Network, which oversees transplants in the U.S. In America, even masks are only a suggestion.