The following is a brief summary of surveyed guidance from publicly available recommendations from organ donation and transplantation groups compiled in partnership with Canadian Blood Services (CBS), Canadian Society of Transplantation (CST) and Canadian Donation and Transplantation Research Program (CDTRP). These vary from international societies such as The Transplantation Society to national bodies. The summaries will be updated regularly as new and revised recommendations become available.
This is not meant to be a comprehensive sample of all groups who have made COVID-19 related recommendations. The first group of documents analyzed were those that had been collated on The Transplantation Society website at the time of review. Further revisions of these summaries will include documents and recommendations from other groups as they become available and based on feedback from the ODT community.
The statements summarized below are expert opinions and/or consensus-based statements/recommendations published by various individuals or societies, internationally. Preliminary statements related to transplantation in the setting of COVID-19 were systematically searched. The summarized statements may not necessarily be based on empirical evidence, nor considering patient’s values and preferences. Please note that none of these are meant to serve as official guideline recommendations for healthcare providers and decision makers endorsed by the Canadian Donation and Transplantation Research Program or Canadian Blood Services.
The final update for this project was on April 30, 2021. No other updates will be available past this date.
While we recognize the distinction between the viral pathogen SARS-CoV-2 and COVID-19, the illness caused by the virus, in the interest of simplicity and readability, we will refer primarily to COVID-19. For example, when screening potential donors, we will state that we are screening for COVID-19, understanding that the tests are designed to detect evidence of SARS-CoV-2.
Abbreviated terminology used: Y (Yes, to indicate recommendations) / N (No, to indicate not recommended) / NR (No recommendation, to indicate no recommendation offered from institution). Click on underlined letters to view recommendations.
Project Leads: Matthew Weiss, Allison Mah. Special thank you: Laura Hornby, Chelsea Patriquin, Jehan Lalani, Fatima Dharsee, Christina Parsons, Kyle Maru, Daniela Massierer, Minal Borkar-Tipathi, Lauren Westhaver, Christine Wardell, Mackenzie Cullip, Alissa Rutman, Shanshan Lan and Hyunyun Kim.
Last update: April 30, 2021
COVID-19 Screening of Potential Deceased Donors
Testing and Screening for All Patients who are Potential Donors?
There was broad agreement that all patients who are potential deceased donors should undergo some form of COVID-19 testing or screening.
| Region | Institution | Recommend Screening for all Potential Donors? | Recommend screening for respiratory infection symptoms or epidemiologic factors regardless of testing result? | Website/Source of Information |
|---|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | Y | Y | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | Y | NR | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | Y | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | Y | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | Y | Y | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | Y | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | N | Y | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | Y | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | Y | NR | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | Y | NR | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | Y | Y | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | Y | NR | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | Y | Y | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | NR | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | Y | Y | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | Y | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | Y | NR | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | NR | TTS.ORG - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
Nasopharyngeal and Oropharyngeal Swab (Polymerase Chain Reaction) PCR Testing (columns 1 and 2)
Nasopharyngeal (NP) PCR swab was the preferred testing modality of most organizations. In most areas, this is the most routinely performed test and likely the most readily available. Concerns over sensitivity, especially early reports of high rates of false negatives, caused certain groups to recommend other screening in addition to NP swabs, but no group recommended against its use.
Oropharyngeal (OP) PCR swabs were also frequently recommended by groups, often as an alternative to NP swabs. Most groups did not distinguish between NP or OP swabs.
Preferential use of bronchial secretion for PCR Testing (column 3)
Some groups recommend bronchial secretion testing due to suspected increased sensitivity, though with caveats. The first is that collecting sample through bronchoalveolar lavage (BAL) sampling increases the risk of aerosol generation and thus spread of virus if present. Several groups cautioned that if BAL is chosen, it must be done according to local infection guidelines to limit aerosol generation and spread. Alternatively, bronchial secretions could be collected using techniques such as wedged in-line suction that would decrease or eliminate the risk of aerosolization. No organization cited evidence to suggest that one of these methods to collect bronchial secretions has proven improved sensitivity or specificity.
Thoracic computerized tomography (CT) scans in asymptomatic potential donors (column 5)
Most groups made no recommendation regarding the use of CT scan in asymptomatic patients. One group suggests CT scans have the potential to discover radiologic evidence of COVID-19 prior to symptom development in this population. Other organizations recommended against this type of screening. No group cited evidence to suggest that this application of CT screening was effective in diagnosing COVID-19 in patients with negative PCR testing.
Use of blood testing (column 6)
No group recommends the current use of blood work (antibody or serology testing) for clinical decision making.
| Region | Institution | 1. Recommend Nasopharyngeal Swab PCR Testing | 2. Recommend Oropharyngeal Swab PCR Testing | 3. Recommend Preferential use of Bronchial Secretion for PCR Testing | 4. Recommend enhanced testing or procedures for at risk potential donors (e.g. travel history or symptoms)? | 5.Recommendation thoracic CT scan in asymptomatic potential donors? | 6. Recommend use of blood testing when available? | Website/Source of Information |
|---|---|---|---|---|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | Y | Y | Y | Y | Y | NR | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | NR | NR | NR | NR | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | NR | NR | NR | Y | NR | NR | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | NR | NR | NR | Y | NR | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | NR | NR | NR | Y | NR | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | Y | Y | Y | Y | NR | N | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | Y | NR | NR | Y | NR | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | Y | Y | Y | Y | NR | NR | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | Y | NR | N | NR | NR | Y | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | Y | NR | N | N | Y | NR | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | NR | Y | NR | NR | NR | NR | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | Y | Y | Y | NR | N | N | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | Y | Y | Y | NR | NR | NR | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | Y | NR | Y | N | N | NR | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | NR | NR | NR | NR | NR | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | Y | Y | Y | Y | NR | N | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | NR | NR | NR | Y | NR | N | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | Y | Y | Y | Y | N | Y | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | NR | NR | NR | NR | NR | TTS.ORG- pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | NR | NR | NR | NR | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
Excluding donors with documented COVID-19 infection? (column 1)
At the time of this survey of recommendations, all groups explicitly or implicitly excluded donation from COVID-19 positive donors, except the United Network for Organ Sharing/American Society for Transplantation. The United Network for Organ Sharing/American Society for Transplantation offer considerations for proceeding in light of a positive test from a previously infected patient if: 1) the patient is between 21 – 90 days from initial symptoms 2) symptoms have resolved and 3) an infectious disease expert is consulted. This statement acknowledges that positive PCR tests in time-frame from asymptomatic patients most likely represents persistent viral shedding of little significance, rather than active infection. They recommend that any recipient of an organ from this class of donor would require enhanced follow-up due to the unknown infection risk.
Excluding donors with inconclusive COVID-19 screening? (column 2)
Several screened organizations included a comment that patients with inconclusive testing should be excluded as potential donors in certain circumstances, while others suggest these cases may be considered on a case-by-case basis.
| Region | Institution | 1. Recommend excluding donors with documented COVID-19 infection? | 2. Recommend excluding donors with inconclusive COVID-19 screening? | Website/Source of Information |
|---|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | Y | NR | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | Y | Y | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | Y | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | NR | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | Y | Y | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | Y | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | NR | NR | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | N | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | Y | NR | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | Y | NR | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | Y | Y | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | Y | Y | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | Y | Y | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | NR | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | Y | NR | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | Y | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | Y | N | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | NR | TTS.ORG - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
While most groups recommended laboratory screening of patients who are potential donors as detailed above, some also recommended that patients should be excluded based on certain clinical or exposure risk criteria regardless of laboratory findings. For example, the Australian/New Zealand joint recommendation states: “patients with severe bilateral community acquired pneumonia should be excluded regardless of screening results.”
| Region | Institution | Recommendation regarding exclusion of potential donors based on clinical criteria? | Website/Source of Information |
|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | Y | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | Y | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | Y | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | Y | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | Y | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | N | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | NR | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | Y | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | Y | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | N | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | Y | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | Y | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | Y | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | Y | TTS.ORG - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
Four groups commented on acceptance of organs from other countries. No group categorically excluded acceptance of international offers. They instead stated that these offers should be considered based on the epidemiology of the offering location in consultation with the organ donation organization (ODO) medical direction.
| Region | Institution | Recommendation regarding organs offered from other countries? | Website/Source of Information |
|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | NR | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | Y | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | NR | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | NR | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | Y | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | Y | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | NR | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | NR | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | N | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | NR | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | Y | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | TTS.ORG - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
While several groups recommended protocols or algorithms to determine when a patient with previously confirmed COVID-19 could be considered a potential donor, there was substantial variability in the details of those algorithms. Waiting periods after resolution of symptoms varied from 14 to 28 days. Most, but not all, groups specifically recommended repeat testing after symptom resolution, with some requiring a single negative test and others two tests. Clarification in this area will become increasingly important as the incidence of COVID-19 increases and more patients with a recent history of COVID-19 become potential donors due to unrelated illness or injuries.
| Region | Institution | Recommend testing regimen for documenting clearance of confirmed cases? | Website/Source of Information |
|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | Y | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | NR | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | Y | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | Y | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | N | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | N | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | NR | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | Y | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | Y | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | Y | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | Y | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | Y | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | Y | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | TTS.ORG - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | Y | https://www.myast.org/covid-19-information https://unos.org/covid/ |
The International Liver Transplantation Society (Feb. 2020), specifically recommended avoiding recovery from donors within endemic or high prevalence areas. Several other organizations surveyed suggested this recommendation be considered.
| Region | Institution | Recommend avoiding retrieval from donors within endemic/high prevalence areas | Website/Source of Information |
|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | NR | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | Y | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | Y | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | NR | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | Y | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | NR | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | NR | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | NR | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | NR | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | NR | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | Y | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | NR | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | TTS.ORG- pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
Exposure Assessment and Recipient Screening Recommendations
Societies generally recommend that prospective recipients of both living and deceased organ donation undergo symptomatic and viral PCR testing prior to transplant. Few societies comment on the use of CT chest imaging in potential donors to assess for findings of COVID-19 and in those that do they either recommend or conditionally recommend that this modality may be used.
International societies do not specifically address enhanced testing or assessment measures for potential recipients with known, recent COVID-19 positive contacts. It is recommended that these donors be deferred for 14 days from last contact.
| Region | Institution | Recommendation regarding testing or symptom screening of potential deceased donation recipients? | Recommendation regarding testing of potential living donation recipients? | Recommend a wait time prior to consideration for donation after exposure to a known COVID-19 positive contact? | Recommend CT scan for potential donors? | Recommend additional screening/testing for prior to consideration for donation after exposure to a known COVID-19 positive contact? | Website/Source of Information |
|---|---|---|---|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | Y | NR | Y | Y | Y | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | NR | NR | NR | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | NR | NR | NR | NR | NR | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | Y | NR | Y | NR | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | NR | NR | NR | NR | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | Y | Y | NR | NR | NR | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | Y | NR | NR | NR | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | N | Y | NR | NR | NR | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | NR | NR | NR | NR | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | Y | NR | NR | Y | NR | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Society | Y | Y | NR | NR | NR | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | Y | Y | NR | NR | NR | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | Y | Y | Y | NR | NR | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | Y | Y | Y | Y | Y | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | Y | Y | Y | NR | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | Y | Y | NR | N | NR | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | Y | NR | NR | NR | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | Y | Y | NR | NR | NR | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | NR | NR | NR | NR | TTS.ORG website - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | NR | NR | NR | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
If a transplant candidate develops COVID-19, societies most commonly recommend resolution of symptoms, at least 2 negative PCR tests and 14 days elapse before considering transplant eligible. Some groups recommend longer waiting periods of 21 or 28 days. Few societies comment on the possibility of lung transplant in individuals with severe lung disease related to COVID-19 and recommend a cautious and limited approach.
| Region | Institution | Recommend wait time prior to transplant if travelled in an endemic area? | Recommend screening regimen to confirm clearance of COVID-19 for waitlist patients? | Recommend lung transplantation for patients with COVID-19 related lung diseases? | Recommend adding COVID-19 testing status to registry data? | Website/Source of Information |
|---|---|---|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | NR | Y | Y | NR | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | Y | NR | NR | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | Y | Y | NR | Y | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | NR | NR | NR | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | Y | NR | NR | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | NR | NR | NR | Y | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | NR | NR | NR | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | NR | NR | NR | NR | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | NR | NR | NR | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | NR | NR | NR | NR | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | NR | NR | Y | NR | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | NR | Y | NR | NR | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | NR | N | NR | Y | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | Y | Y | NR | NR | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | NR | NR | NR | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | Y | Y | NR | Y | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | NR | NR | NR | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | NR | NR | NR | NR | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | NR | NR | NR | TTS.ORG website - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | NR | NR | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
Post-Transplant Risk
There is limited guidance related to lymphocyte depleting therapy with most societies providing no recommendation in this regard. Similarly, most organizations make no recommendation about altering maintenance immunosuppression, though some explicitly recommend against adjustment of maintenance immunosuppression in asymptomatic transplant recipients.
Societies either do not comment or recommend against prophylactic anti-SARS-CoV-2 therapy at this time. ISHLT encourages enrollment of transplant recipients and individuals with chronic lung or cardiac disease into trials of prophylactic and therapeutic therapies.
Many organizations make no recommendation with regard to antiviral treatment of COVID-19. Some explicitly state there is not enough evidence to guide decisions regarding the use of COVID-19 treatment strategies in transplant patients. Other organizations do recommend specific antiviral treatments, although these vary significantly between organizations and are dependent on disease severity and underlying health conditions.
| Region | Institution | Recommend avoidance or decrease of lymphocyte depleting regimens immediately post-transplant? | Recommend altering immunosuppression regimen in transplant patients not currently infected with COVID-19? | Recommend prophylactic anti-COVID-19 therapy? | Recommend modulation of immunosuppression if transplant recipient tests positive for COVID-19? | Recommend transplant recipient who tests positive for COVID-19 change immunotherapy themselves? | Recommend for or against specific anti-COVID-19 therapy? | Website/Source of Information |
|---|---|---|---|---|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | N | N | NR | Y | N | N | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | NR | NR | NR | NR | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | NR | NR | NR | NR | NR | NR | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| International Society of Nephrology | https://www.theisn.org/covid19/recommendations | |||||||
| Asia | Indian Society of Transplantation | NR | NR | Y | NR | NR | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | NR | NR | NR | NR | NR | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | NR | NR | NR | NR | NR | NR | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | NR | NR | NR | NR | NR | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | NR | NR | NR | NR | NR | NR | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | NR | NR | NR | NR | NR | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | NR | NR | NR | NR | NR | NR | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | NR | N | NR | N | NR | NR | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | NR | NR | NR | NR | NR | NR | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | NR | NR | NR | NR | NR | NR | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | Y | Y | Y | Y | Y | Y | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | NR | NR | NR | NR | NR | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | NR | N | NR | Y | Y | Y | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | NR | N | N | Y | NR | N | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | NR | N | N | Y | N | NR | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | NR | NR | NR | NR | NR | TTS.ORG website - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | NR | NR | NR | NR | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
Although several societies advise that there may be an increased risk of acquisition of SARS-CoV-2 infection or a greater severity of disease, it is acknowledged that this is largely unknown. The recommendations provided about management of transplant recipients to reduce the risk of disease acquisition are in line with local public health recommendations and include a recommendation to self-isolate after international travel and to follow public health guidance pertaining to hand hygiene and social distancing. Regarding the wearing of masks, some jurisdictions recommend this for all individuals when in public which also applies to transplant recipients. Masks are especially recommended for any symptomatic transplant recipient to be worn during evaluation for COVID-19.
| Region | Institution | Recommendation on self-isolation on return from travel? | Recommendation on PPE for transplant recipients visiting hospital or other high risk situation? | Recommend transplanted patients alter daily routine (e.g. self-isolation or hygiene)? | Comment on risk of viral acquisition or severe disease for immunosuppressed patients? | Recommend limitation of visitors to post-transplant recipients? | Recommendation on transplant recipients wearing masks in daily life? | Website/Source of Information |
|---|---|---|---|---|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | NR | Y | Y | Y | Y | Y | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | Y | NR | Y | NR | NR | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | NR | Y | Y | NR | NR | NR | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| International Society of Nephrology | N/A | N/A | N/A | N/A | N/A | N/A | https://www.theisn.org/covid19/recommendations | |
| Asia | Indian Society of Transplantation | Y | Y | Y | NR | NR | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | Y | Y | NR | NR | NR | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | NR | NR | NR | NR | NR | NR | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | NR | NR | NR | Y | NR | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | Y | Y | NR | NR | NR | NR | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | NR | NR | NR | NR | NR | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | NR | Y | NR | Y | NR | NR | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | NR | NR | Y | Y | Y | NR | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | NR | NR | NR | NR | NR | NR | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | Y | NR | Y | NR | NR | NR | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | Y | Y | N | Y | N | N | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | NR | Y | Y | NR | NR | N | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | Y | Y | Y | Y | NR | NR | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | NR | NR | NR | NR | NR | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | NR | NR | NR | NR | NR | NR | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | NR | NR | NR | NR | NR | TTS.ORG website - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | Y | Y | Y | NR | Y | https://www.myast.org/covid-19-information https://unos.org/covid/ |
Society guidance recommendations align with hospital infection prevention and control as well as public health recommendations where COVID-19 positive patients should be geographically separated from transplant wards and any suspected COVID-19 positive patient should be alerted to public health. In an effort to minimize transmission, several societies recommend limiting non-essential clinic and diagnostic appointments and limiting visitors. Transplant recipients with fever or respiratory or gastrointestinal symptoms should inform their transplant team.
| Region | Institution | Recommendation on when transplant recipient should contact provider? | Recommend limiting reduction in hospital visits or contact with healthcare workers for transplanted patients ? | Recommend limitation of visitors to post-transplant recipients? | Recommend physical separation of transplant recipients within hospitals from COVID-19 + patients? | Recommendation on contacting public health authority with suspected COVID-19 + patient? | Website/Source of Information |
|---|---|---|---|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | NR | NR | NR | NR | NR | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | NR | NR | NR | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | NR | Y | NR | NR | Y | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| International Society of Nephrology | N/A | N/A | N/A | N/A | N/A | https://www.theisn.org/covid19/recommendations | |
| Asia | Indian Society of Transplantation | Y | Y | NR | NR | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | NR | NR | NR | NR | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | NR | NR | NR | NR | Y | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | NR | NR | NR | NR | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | NR | Y | NR | NR | NR | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | NR | NR | NR | NR | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | NR | NR | NR | NR | NR | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | Y | Y | Y | Y | NR | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | NR | NR | NR | NR | NR | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | Y | Y | NR | Y | NR | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | Y | Y | N | Y | NR | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | Y | Y | NR | NR | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | NR | Y | Y | Y | Y | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | NR | NR | NR | NR | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | NR | NR | NR | NR | NR | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | NR | NR | NR | NR | TTS.ORG website - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | Y | NR | NR | NR | Y | https://www.myast.org/covid-19-information https://unos.org/covid/ |
Deceased Donation Recommendations
No group recommends outright suspension of all deceased donation and transplant activity. As long as it is considered safe, most groups recommend proceeding with donation and transplantation be assessed on a case by case basis. One group suggests temporary suspension of the deceased donor program be considered when resources at the transplant center may be constrained.
No group recommends outright suspension of all deceased donation and transplant activity. As long as it is considered safe, most groups recommend proceeding with donation and transplantation be assessed on a case by case basis. One group suggests temporary suspension of the deceased donor program be considered when resources at the transplant center may be constrained.
| Region | Institution | Recommendation on suspension of deceased kidney/pancreas donation? | Website/Source |
|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | NR | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | Y | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | NR | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | Y | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | Y | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | Y | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | N | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | NR | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | N | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | NR | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | Y | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | NR | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | N | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | TTS.ORG - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
No group recommends outright suspension of all deceased donation and transplant activity. As long as it is considered safe, most groups recommend proceeding with donation and transplantation be assessed on a case by case basis. One group suggests temporary suspension of the deceased donor program be considered when resources at the transplant center may be constrained.
| Region | Institution | Recommendation on suspension of deceased liver donation? | Recommend alteration of deceased liver organ donation and transplantation? | Website/Source of Information |
|---|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | NR | NR | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | Y | NR | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | NR | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | NR | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | NR | NR | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | NR | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | Y | NR | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | Y | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | Y | Y | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | N | NR | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | N | N | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | N | NR | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | N | N | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | Y | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | N | N | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | NR | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | NR | NR | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | NR | TTS.ORG website - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
No group recommends outright suspension of all deceased donation and transplant activity. As long as it is considered safe, most groups recommend proceeding with donation and transplantation be assessed on a case by case basis. One group suggests temporary suspension of the deceased donor program be considered when resources at the transplant center may be constrained.
| Region | Institution | Recommendation on suspension of thoracic organ donation and transplantation? | Recommend alteration of thoracic organ donation and transplantation? | Recommendation on cardiac donation and transplantation? | Recommendation on suspension of pulmonary donation and transplantation? | Website/Source of Information |
|---|---|---|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | N | Y | Y | Y | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | NR | NR | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | Y | NR | NR | NR | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | NR | NR | NR | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | NR | NR | NR | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | NR | NR | NR | NR | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | NR | NR | NR | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | Y | Y | Y | Y | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | NR | Y | Y | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | N | Y | Y | Y | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | N | NR | N | N | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | N | N | N | N | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | N | N | N | N | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | N | Y | Y | Y | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | NR | NR | NR | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | NR | NR | NR | NR | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | NR | NR | NR | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | NR | NR | NR | NR | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | NR | NR | NR | TTS.ORG website - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | NR | NR | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
Living Donation / Paired Donation Recommendations
No group recommends outright suspension of all living donation/paired exchange activity. As long as it is considered safe, most groups recommend proceeding with donation and transplantation be assessed on a case by case basis. One group suggests temporary suspension of the deceased donor program be considered when resources at the transplant center may be constrained.
The majority of guidance recommends symptom screening and PCR testing of all living donors. There is limited and variable guidance around management of living donors with a prior history of resolved COVID-19.
If these programs or individual transplants continue, it is uniformly recommended that potential living donors take every measure to limit the acquisition of COVID-19 prior to donation. Some programs suggest this should include deferral of donation and self isolation for 14 – 21 days after international travel and strict social distancing measures in the 14 days leading up to transplant.
| Region | Institution | Recommend current suspension of Living Kidney Donation? | Recommend current suspension of Living Liver Donation? | Recommend symptom screening of potential living donors? | Recommend wait period after international travel or other epidemiological risk prior to consideration for living donation? | Recommend COVID-19 testing of all potential living donors? | Recommend testing regimen for documenting clearance of confirmed COVID-19 in potential living donors? | Recommend social distancing/no travel etc. for potential living donors? | Recommend suspending KPD programs? | Website/Source of Information |
|---|---|---|---|---|---|---|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | NR | NR | NR | NR | NR | NR | NR | NR | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | NR | NR | Y | NR | NR | NR | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | Y | Y | Y | Y | N | NR | NR | NR | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | Y | Y | Y | NR | Y | NR | NR | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | N | N | Y | Y | Y | NR | NR | NR | ||
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | NR | NR | NR | NR | Y | Y | NR | NR | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | NR | NR | NR | Y | Y | NR | NR | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | NR | NR | NR | NR | NR | NR | NR | NR | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | N | NR | Y | NR | NR | NR | NR | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | Y | NR | NR | NR | NR | NR | NR | NR | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | Y | Y | Y | NR | NR | NR | NR | NR | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | N | N | Y | N | Y | Y | NR | NR | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | NR | NR | Y | NR | N | Y | Y | NR | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | N | N | Y | Y | Y | Y | Y | NR | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | NR | NR | NR | NR | NR | NR | NR | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | N | N | Y | Y | Y | Y | Y | Y | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | N | N | Y | NR | Y | NR | NR | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | N | N | Y | Y | Y | Y | Y | Y | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | NR | NR | NR | NR | NR | NR | NR | TTS.ORG website - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | NR | NR | NR | NR | NR | NR | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
Organ Donation and Transplant Professionals’ Personal Protective Equipment (PPE) use
Recommendations for ODT professionals following contact with COVID-19 confirmed or suspected patients (column 2)
The groups that commented on this issue generally recommended that ODT staff should follow existing recommendations for other health care professionals after confirmed or potential COVID-19 exposure.
Routine use (columns 3 and 5)
Most groups issued recommendations regarding PPE use. Most commonly they encouraged adherence to national and local practices regarding the types of PPE used in different situations. Some specifically noted that full and adequate PPE must be made available to ODT professionals, either through the associated organ donation organization (ODO) or hospital system. A few organizations recommended routine use of universal precautions (surgical mask and gloves) for all patient encounters, regardless of local recommendations.
PPE requirements for ODT professionals during potentially aerosolizing procedures (e.g. bronchoscopy or extubation in the operating room) (column 4)
Some groups specifically mention airborne transmission precautions and the need to ensure that ODT professionals have access to appropriate equipment – particularly N95 masks – if they are present during these procedures.
Alteration of staff routine to decrease transmission (columns 5 and 6)
Several groups recommend that ODOs should alter their routines to encourage social distancing as much as possible. Suggested means included encouraging of videoconferencing, limiting of staff travel between hospitals when possible, and following social distancing protocols in ODO offices or facilities. One group mentioned that consideration should be given for staff with underlying risk factors for disease severity (e.g. immunosuppression, advanced age) to avoid unnecessary presence in hospitals or direct patient contact.
| Region | Institution | 1. Include Recommendations for ODT professionals' PPE Use | 2. Recommend following hospital procedures when in contact with COVID-19 + or suspected patients | 3. Recommend application of routine surgical masks and gloves for all patient encounters | 4. Recommend PPE requirements for certain procedures (e.g. bronchoscopy or OR)? | 5. Recommend alteration of staff routine (e.g. decreasing face to face interactions, working from home)? | 6. Recommend alteration of staff requirements for certain populations? | Website/Source of Information |
|---|---|---|---|---|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | Y | NR | NR | Y | Y | NR | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | Y | NR | NR | NR | NR | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | NR | NR | NR | NR | NR | NR | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | Y | Y | NR | NR | Y | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | Y | Y | Y | NR | Y | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | Y | NR | NR | NR | NR | NR | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | Y | NR | NR | NR | Y | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | NR | NR | NR | NR | NR | NR | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | NR | NR | NR | NR | NR | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | NR | NR | NR | NR | NR | NR | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | Y | NR | NR | NR | NR | NR | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | NR | NR | NR | NR | NR | NR | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | Y | Y | N | N | Y | NR | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | Y | Y | Y | Y | N | N | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | NR | NR | NR | NR | NR | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | Y | Y | Y | Y | Y | Y | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | NR | NR | NR | NR | NR | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | Y | Y | Y | Y | Y | NR | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | NR | NR | NR | NR | NR | TTS.ORG website - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | Y | Y | Y | Y | NR | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
Additional Recommendations
Need to inform potential recipients regarding issues around COVID-19 infection risk or need for enhanced isolation post-transplant (column 1)
Many groups recommended that if a transplantation was deemed medically necessary during the pandemic, potential recipients should be clearly informed of the additional potential risks of COVID-19 infection post-transplant and that strict, prolonged isolation would likely be required.
Consideration balance of liberating intensive care unit (ICU) resources through successful transplantation against ICU need post-transplantation (column 2)
Almost all groups recognized the potential for the pandemic to create surge demand for ICU resources that would strain a hospital’s capacity to care for patients who are potential donors or recipients requiring ICU post-transplant. However, some groups mentioned that the need to limit excess burden on the system through donation and transplantation must be balanced against the potential to liberate ICU resources through transplantation. They state that transplanting a patient hospitalized in the ICU for terminal hepatic or cardiac failure might actually decrease overall system burden by allowing that patient to be transferred to the ward. All groups were careful to state that these decisions must be made considering current conditions of the entire health system and that sweeping recommendations that would apply to all cases would not be possible.
Risk of transplant may outweigh benefit
Several transplantation groups stated that while the medical and societal benefits of transplant in ordinary times are clear, in general, it is advised to undertake a risk assessment to determine which patients would benefit from transplant, despite increased risk of infection.
| Region | Institution | 1. Recommend informing potential recipients specifically regarding issues such COVID-19 infection risk or need for enhanced isolation post-transplant? | 2. Recommend consideration balance of liberating ICU resources through successful transplantation against ICU need post-transplantation? | 3. Recommends risk of transplant may out weigh benefit | 4. Recommends ensure recipient is available for organs prior to initiation | Website/Source of Information |
|---|---|---|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | Y | Y | NR | NR | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | NR | NR | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | NR | Y | NR | NR | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | Y | NR | NR | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | NR | NR | NR | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | NR | NR | NR | NR | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | NR | NR | NR | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | NR | NR | NR | NR | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | Y | NR | NR | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | NR | NR | Y | Y | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | NR | NR | Y | NR | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | NR | NR | NR | NR | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | Y | Y | Y | NR | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | Y | Y | Y | Y | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | NR | NR | NR | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | Y | Y | Y | Y | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | NR | NR | NR | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | Y | NR | NR | NR | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | NR | NR | NR | TTS website - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | NR | NR | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
Ensure recipient and equipment is available for organs prior to initiation (columns 1 and 4)
Considering the decreased availability of resources, especially during the early stages of the pandemic, it is recommended that ODOs and transplant programs ensure that there are potential recipients who are medically eligible and willing to receive the organ prior to committing resources to the donation and recovery process. This recognizes that it would be inadvisable in a resource limited setting to commit ICU or ODO resources to cases that are unlikely to proceed to actual donation and transplantation. Ensuring an adequate supply of PPE, ventilators and blood products is also recommended.
Local recovery team and shipping of organs (column 1)
Several groups recommended that in the case where the donor and recipient are in different geographic locations, recovery should be performed by local teams whenever possible and the organ shipped in order to limit the amount of travel required by recovery teams.
Transplantation in a designated non-COVID-19 facility with limited exposure to potential COVID-19 patients (columns 2 and 6)
While not available in all systems, a few groups recommended that when possible transplantation and subsequent care should take place in facilities or sections of a hospital that are designated as COVID-19 free and capable of admitting only patients who are confirmed or suspected to be COVID-19.
| Region | Institution | 1. Recommends ensure recipient is available for organs prior to initiation | 2. Recommend local recovery team and shipping of organs? | 3. Recommend transplant take place in a designated non-COVID-19 facility? | 4. Recommend listing or transplanting waitlisted patients in a geographic area with less viral transmission? | 5. Recommend confirmation of equipment (PPE etc.) prior to acceptance of organ offer? | 6. Recommend decreased need for post-transplant follow-up reporting or data entry? | 7. Recommend isolation of recipients from patients with inconclusive screening? | Website/Source of Information |
|---|---|---|---|---|---|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | NR | Y | NR | NR | Y | NR | NR | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | NR | NR | NR | NR | NR | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | NR | NR | NR | NR | NR | NR | Y | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | NR | NR | Y | NR | NR | NR | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | NR | NR | NR | NR | NR | NR | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | NR | NR | NR | NR | NR | NR | NR | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | NR | NR | Y | NR | NR | NR | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | NR | NR | NR | NR | NR | NR | NR | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | NR | NR | NR | NR | NR | NR | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | Y | Y | NR | NR | NR | NR | NR | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | NR | Y | Y | NR | NR | NR | NR | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | NR | NR | NR | NR | NR | NR | NR | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | NR | NR | Y | NR | NR | NR | NR | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | NR | Y | Y | Y | Y | N | N | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | NR | NR | NR | NR | NR | NR | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | Y | NR | Y | NR | Y | NR | NR | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | NR | NR | NR | NR | NR | NR | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | NR | Y | NR | NR | NR | NR | NR | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | NR | NR | NR | NR | NR | NR | TTS website - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | NR | NR | NR | NR | NR | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
International guidance documents recognize that transplant candidates on the waitlist are potentially at greater risk of complications related to COVID-19 given their end stage organ disease status and the requirement to defer transplant if they become infected. However, there is minimal guidance regarding enhanced screening and testing in wait list patients.
| Region | Institutions | Recommendation or comment on risk of COVID infection for patients waitlisted for transplantation? | Recommend limiting reduction in hospital visits or contact with healthcare workers for waitlisted patients ? | Recommend alteration of routine surveillance of waitlisted patients? | Recommend waitlisted patients alter daily routine (e.g. self-isolation or hygiene)? | Recommend enhanced screening or testing of waitlist patients for COVID-19 | Recommendation on number of patients in a room? | Website/Source of Information |
|---|---|---|---|---|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | Y | Y | N | N | Y | NR | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | NR | NR | NR | NR | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | Y | Y | Y | Y | NR | NR | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | Y | Y | NR | NR | NR | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | NR | NR | NR | NR | Y | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | NR | NR | NR | NR | NR | NR | International Dropbox |
| Europe | European Centre for Disease Prevention and Control | NR | NR | NR | NR | NR | Y | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | NR | NR | NR | NR | NR | NR | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | NR | NR | NR | NR | NR | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | NR | NR | NR | NR | NR | NR | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | Y | Y | NR | NR | NR | NR | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | NR | NR | NR | NR | NR | NR | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | Y | Y | N | NR | Y | Y | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | Y | N | Y | N | Y | N | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | NR | NR | NR | NR | NR | NR | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | Y | Y | Y | NR | NR | Y | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | NR | NR | NR | NR | NR | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | NR | NR | NR | NR | NR | NR | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | NR | Y | NR | N | NR | TTS website - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | NR | NR | NR | NR | NR | NR | https://www.myast.org/covid-19-information https://unos.org/covid/ |
Most organizations suggest the potential advantages of vaccination in transplant recipients outweighs any potential concerns about reduced efficacy and/ or perceived lack of safety. Accordingly, these organizations recommend transplant recipients should receive the COVID-19 vaccine. In immediate pre- and post- transplantation settings, the ideal timing of vaccination is uncertain and recommendations vary.
| Region | Institution | Recommend transplant recipients receive the COVID vaccine | Recommend when transplant recipients should be vaccinated post-transplant? | Recommend when wait-list candidates should be vaccinated pre-transplant? | Website/Source of Information |
|---|---|---|---|---|---|
| International | The International Society of Heart and Lung Transplantation | Y | Y | Y | https://ishlt.org/ishlt/media/documents/SARS-CoV-2_-Guidance-for-Cardiothoracic-Transplant-and-VAD-centers.pdf |
| International Liver Transplant Society | NR | NR | NR | https://ilts.org/covid-19-statement-from-the-infectious-diseases-and-liver-transplantation-sig/ | |
| The Transplantation Society | Y | Y | Y | https://tts.org/index.php?option=com_content&view=article&id=749&Itemid=140 | |
| Asia | Indian Society of Transplantation | NR | NR | NR | https://isot.co.in/file/ISOT_COVID_V1_March_26.pdf |
| Korean Society for Transplantation | NR | NR | NR | http://www.mykst.org/board/list.html?num=700&start=0&sort=top%20desc,reg_dt%20desc&code=m_notice&key=&keyword= | |
| Australasia | Australian Government Organ and Tissue Authority and The Transplantation Society of Australia and New Zealand | NR | NR | NR | https://www.tsanz.com.au/ |
| Europe | European Centre for Disease Prevention and Control | NR | NR | NR | https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-supply-substances-human-origin.pdf |
| European Society of Transplantation | NR | NR | NR | https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians | |
| Agence de la Biomédecine | NR | NR | NR | https://content.tts.org/content/covid19/france-Agency-of-the-Biomedicine.pdf | |
| Belgian Transplantation Society | NR | NR | NR | https://www.eurotransplant.org/wp-content/uploads/2020/04/BTS-position-paper_ET-letter.pdf | |
| Dutch Transplantation Foundation | Y | Y | Y | https://www.transplantatiestichting.nl/nieuwsartikel/covid-19-en-donatie | |
| Organización Nacional de Trasplantes | NR | NR | NR | https://content.tts.org/content/covid19/COVID-19-Summary-of-Spanish-recommendations-on-organ-donation-and-transplantation20200413.pdf | |
| NHS Blood and Transplant | Y | Y | Y | https://www.odt.nhs.uk/deceased-donation/covid-19-advice-for-clinicians/ | |
| Swisstransplant | NR | NR | NR | English fact sheet: https://content.tts.org/content/covid19/Swiss-Transplant-Fact-sheet-concerning%20donors.pdf | |
| Latin America | Brazilian Association of Organ Transplantation | Y | N | N | http://www.abto.org.br/abtov03/default.aspx?mn=476&c=0&s=157 |
| North America | American Association For The Study Of Liver Diseases | Y | Y | NR | https://www.aasld.org/sites/default/files/2020-05/AASLD-COVID19-ClinicalInsights-May142020-FINAL-v2.pdf |
| American Society of Transplant Surgeons | NR | NR | NR | https://asts.org/advocacy/covid-19-resources/asts-covid-19-strike-force#.Xqhd2MhKiUl | |
| Canadian Blood Services and Canadian Society of Transplantation | Y | Y | Y | https://professionaleducation.blood.ca/en/organs-and-tissues/covid-19-update-organ-donation-and-transplantation-services | |
| Organ Procurement and Transplantation Network | NR | NR | NR | TTS website - pdf Information for transplant programs | |
| United Network for Organ Sharing/American Society for Transplantation | Y | Y | Y | https://www.myast.org/covid-19-information https://unos.org/covid/ |
ity of Alberta and has received training in patient-oriented research through the University of Calgary’s PACER (Patient and Community Engagement Research) Program. He is the Patient, Family, and Donor Partnerships & Education Manager with the Canadian Donation and Transplantation Research Program. In this role, Manuel builds relationships patient partners with investigators and strengthens capacity among CDTRP patient partners.
Anders Billström 
Gareth Wiltshire
K
Sherrie Logan 
born and raised in Edmonton, AB. With a degree in Music Performance (saxophone performance) and Education, Lindsey has taught for over a decade in the Edmonton Public School system. When she is not teaching, she is very involved in the music community, performing in the Edmonton Winds, conducting her own community ensemble (The Beer League Band) and on numerous musical boards across the province. For the past 5 years, Lindsey has had to take a break from teaching after having her amazing son, George. Maternity leave did not goes as expected as George was diagnosed with Dilated Cardiomyopathy at 5 months old and required 2 heart transplants before the age of 4. During this time, Lindsey has also began to dedicate her time building and expanding her charity: Big Gifts for Little Lives, where they raise money to fund Pediatric Heart Transplant research at the Stollery.
Dr. Caigan Du is a scientist at the Vancouver Coastal Health Research Institute and an assistant professor in the Department of Urologic Sciences at the University of British Columbia. He received a Ph.D. degree in Biochemistry in UK and postdoctoral training in Immunology in USA. He is interested in the pathogenesis of kidney ischemia-reperfusion injury and transplant rejection, and molecular control of urinary malignancies. He has been studying the impact of kidney donor-derived factors on renal allograft rejection, and the molecular pathways of kidney injury and regeneration in experimental models. He is also interested in developing medical solution including drugs made from natural compounds for all kinds of health problems, including immune disorders, organ preservation, kidney failure and urinary cancer. He is the PI of many grant supports from the Kidney Foundation of Canada and the Canadian Institutes of Health Research.
Heather Badenoch is a non-directed living liver donor and communications strategist. As the president of Village PR, she provides strategic communications direction and training to not-for-profit clients in community and health. An active transplant volunteer, Heather helps transplant candidates find living donors by running their public appeals, small and large, pro-bono. She also mentors potential living donors on the path to living donation. Heather is a volunteer with the UHN Centre for Living Organ Donation and the Canadian Donation and Transplant Research Program. She and her spouse adopt rescue dogs and volunteer together with Community Veterinary Outreach, a group providing free veterinary care to the pets of people who are homeless.
Sean Dicks is a clinical psychologist who has 20 years’ experience supporting both families of organ donors and transplant recipients. While it is rare for him to have contact with a donor family and recipient linked to the same organ donation-transplantation event, his contact with families who have lived experience with organ donation on the one hand, and patients who have received transplants on the other hand has provided opportunities to explore how their journeys become linked when they attempt to make sense of and find meaning in their respective crises.
Terri Hansen-Gardiner is a Cree speaking Metis woman from Northern Saskatchewan as well as a 10 year Breast Cancer Survivor. Her tireless spirit and dedication to her community is undeniable. Terri is a cancer survivor who travels around the province to provide assistance, information, and support to Indigenous patients who are trying to access and navigate the cancer care system.
Dr. Golnaz Karoubi is Assistant Scientist at the Toronto General HospitalResearch Institute and principal investigator in the Latner Thoracic Research Labs. She currently holds an Assistant Professor appointment in the department of Laboratory Medicine and Pathobiology and a cross-appointment in the department of Mechanical and Industrial Engineering at the University of Toronto. Dr. Karoubi received her PhD in Applied Science and Engineering at the University of Toronto and joined the Lung Regenerative Medicine Program in the Department of Clinical Research in Berne University, Switzerland for a post-doctoral research fellowship. She stayed on as a Group Leader in 2008 to direct the basic and transitional science as related to Cancer Stem Cell and Lung Regenerative Medicine in the Department of Biomedical Research at the University of Berne until 2012. In early 2012, she joined the team of Dr. Tom Waddell at the Toronto General Hospital Research Institute as a Senior Scientific Associate and was appointed to Assistant Scientist at the Toronto General Hospital Research Institute (University Health Network) in November 2019 and to Assistant Professor in the Department of Laboratory Medicine and Pathobiology in July 2020.
Dr. Haykal graduated from the University of Ottawa Faculty of Medicine in2007 as class valedictorian and silver medalist, and subsequently completed her residency training in Plastic and Reconstructive Surgery at the University of Toronto in 2016. During her residency, she completed a four-year Doctorate of Philosophy (PhD) in tissue engineering, regenerative medicine and immunology with a focus on tracheal reconstruction. She obtained numerous grants and awards including a CIHR Vanier Scholarship. Dr. Haykal then pursued fellowship training in microsurgical reconstruction at the Albany Medical Centre in New York. Dr. Haykal joined the University Health Network and the Toronto General Hospital in 2018. Her clinical focus is on complex oncological reconstruction and microsurgical reconstruction of the breast, head and neck and extremity. She started a lymphedema program in 2019 where she offers microsurgical techniques for the treatment of lymphedema.
Dr. Ahmed is a Professor in the Cumming School of Medicine at the University of Calgary. The recipient of the 2022 Hypertension Canada Senior Investigator Award, she is a nephrologist and clinician-scientist with a focus on sex and gender differences in human cardiovascular/kidney physiology and clinical outcomes. Dr. Ahmed is the Vice Chair (Research) for the Department of Medicine, Lead of the Libin Institute Women’s Cardiovascular Health Research Initiative at the University of Calgary and Lead of the Alberta Strategy for Patient Oriented Research Capacity Development Platform. Dr. Ahmed is an Advisory Board member for the Canadian Institutes of Health Research Institute of Gender and Health, a member of the Canadian Medical Association Journal Governing Council and the President-Elect for the Organization for the Study of Sex Differences.
r. Christopher Nguan is an Associate Professor at the University of British Columbia in the Department of Urological Sciences, Surgical Head of Kidney Transplantation at Vancouver General Hospital and the Director of the Surgical Technologies Experimental Laboratory & Advanced Robotics (STELLAR) facility at Vancouver General Hospital.
r Caroline Lamarche is a clinician scientist and transplant nephrologist at Maisonneuve-Rosemont Hospital. She is an assistant clinical professor at the Université de Montréal. After her nephrology training at the Université de Montréal (2015), she completed a Master degree on the use of adoptive immunotherapy to treat/prevent BK nephropathy in kidney transplant recipients. She then pursued a post-doctoral fellowship with Dr. Megan Levings at the University of British Columbia on the use of chimeric antigen receptor (CAR) regulatory T cells (Tregs) to induce transplant tolerance. Her lab is working on the development of adoptive immunotherapy in nephrology and understanding Treg dysfunction.
Dr. Tandon is an Associate Professor of Medicine, Co-Director of the Cirrhosis Care Clinic, Transplant Hepatologist and lead of the Cirrhosis Care Alberta quality improvement program. She obtained her training at the University of Alberta, the Hospital Clinic in Barcelona and Yale University. Her clinical practice and research are focused on cirrhosis with research interests including cirrhosis related complications, malnutrition, frailty, exercise therapy, palliative care, integrative health approaches such as meditation and knowledge translation. It is her career goal to provide wholistic, interdisciplinary, evidence based, patient-centered care through education, empowerment, engagement and team-work.
Emily is a PhD student at the University of Alberta, where she completed her Master of Science (MSc) degree in medicine. With a passion for patient-oriented research and a commitment to improving health outcomes, Emily’s doctoral project focuses on EMPOWER, a 12-week online mind-body wellness program designed for adults living with chronic health conditions.
Dr Basil S. Nasir, M.B.B.Ch
Dr. Victor Ferreira is an Assistant Scientist in the Ajmera Transplant Centre at the University Health Network (UHN) and the Toronto General Hospital Research Institute (TGHRI). He is also an Assistant Professor at the University of Toronto in the Department of Laboratory Medicine and Pathobiology (LMP). He completed his PhD in Medical Sciences – Infection and Immunity Specialization at McMaster University in 2014 and post-doctoral training at UHN. His research program is focused on three pillars: I) using systems vaccinology to reveal insights into vaccine responses in immunocompromised individuals like transplant recipients; II) characterizing the impact of chronic viral infection on host immune responses; and III) developing novel methods for eliminating latent viruses in human organs. His work has been cited >2,500 times and is published in journals including the New England Journal of Medicine, Nature Immunology, the Lancet Infectious Diseases, Clinical Infectious Diseases, the American Journal of Transplantation and Journal of Infectious Diseases.
Chemical Engineering as an Assistant Professor in August 2014. She is a biochemical engineer with expertise in bioprocess development, high‑throughput screening and stem cell culture optimization. Her research aims to develop bioprocesses to produce and transplant therapeutic cells to treat diabetes and cardiovascular disease. She notably developed new methods to encapsulate pancreatic islets, as well as vascular biomaterials surface modification strategies which are now applied by other researchers around the world. Her emerging leadership in bioengineering was recognized through the 2014 Martin Sinacore Outstanding Young Investigator Award from Engineering Conferences International & Biogen Idec, as well as the “Étoiles effervescence” award from Montreal InVivo.
Chantal Bémeur is a nutrition specialist in relation to liver disease and its many complications. Professor Bémeur trained as a dietitian/nutritionist and completed her graduate studies and two post-doctoral fellowships in nutrition, focusing on conditions affecting the hepatic and nervous systems, such as hepatic encephalopathy and Leigh Syndrome French Canadian. Professor Bémeur’s research activities are generally of a fundamental and clinical nature, including a collaboration with CHUM’s Department of Hepatology and Gastroenterology. As an expert member of the International Society on Hepatic Encephalopathy and Nitrogen Metabolism, Dr. Bémeur has participated in the development of guidelines on nutrition and liver disease. She is also part of a team of Canadian experts who developed an evidence-based nutritional education guide collaborating with people with chronic liver disease and their caregivers. She received an award from the Ordre professionnel des diététistes du Québec in 2018 for her work on this guide. Dr. Bémeur has published several book chapters, 30 scientific articles and over 100 scientific abstracts. Dr. Bémeur’s co-directs the HepatoNeuro Laboratory in the Cardiometabolic Axis of the Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM). Several organizations, including the Donation and Transplantation Research Program of Canada and the Canadian Institutes of Health Research fund Dr. Bémeur’s research.
Dr Thozama Siyotula is a distinguished paediatric surgeon at Red Cross War Memorial Children’s Hospital in Cape Town, South Africa. With a profound interest in hepatobiliary, transplant, thoracic and neonatal surgical outcomes. She completed her undergraduate training in 2011 at the University of the Witwatersrand in Johannesburg. Furthering her studies she went on to specialise in paediatric surgery through the Colleges of Medicine of South Africa, completing her FCPaedSurg (SA) in 2021 and a master’s in medicine (Paediatric Surgery) in 2021 at the University of Cape Town. She currently works as a paediatric surgeon and transplant surgeon. A senior lecture at the University of Cape Town and course convenor for the 5th year undergraduate paediatric surgery program at the University of Cape Town.
David Thomson is a critical care subspecialist and abdominal transplant surgeon at Groote Schuur Hospital and the University of Cape Town. His interests are deceased donation, ECMO, medical education and system improvement. He created the massive open online course Organ Donation: From Death to Life hosted on Coursera.org to improve education around organ donation and transplantation. He is the immediate past President of the Southern African Transplantation Society and led development on a report on Organ and Tissue Donation in South Africa: Creating a National Strategic Roadmap in collaboration with the International Society for Organ Donation and Procurement. He worked on the World Brain Death Project and is the lead author on the South African Guidelines for Determination of Death published in 2021.
About Dr. Julie Ho
Dr. Tom Blydt-Hansen completed his MD at McGill University, and his Pediatric and Nephrology specialization at the Montreal Children’s Hospital, followed by further specialization in transplantation at the University of California, Los Angeles. He began his Nephrology career at the University of Manitoba in 2001, where he was Division Head of Nephrology from 2005-2014.
Monica Bronowski completed an undergraduate degree in neuroscience at Dalhousie University, with a focus on innovative neurotechnology. Before starting her PhD, she worked in hematology, oncology, and bone marrow transplant (BMT), conducting clinical trials across various study phases for multiple myeloma, bone marrow transplant, and CAR-T therapies. This experience exposed her to both early and late-phase clinical trials, deepening her interest in translational research.
Angela Hamie has just graduated from the University of Alberta and holds a Bachelor of Science with Honors in Immunology and Infection. Her presentation will summarize her research conducted throughout her fourth year undergraduate thesis project, which focuses on the Age, Thymus Excision, Organ Type, and Immunosuppression on Lymphocyte Subpopulations in pediatric transplantation.
Mitchell Wagner is currently a first year medical student at the University of Alberta. He graduated from the U of A in 2022 with an Honors degree in Immunology and Infection with a certificate in biomedical research. He recently defended a Master of Science in Experimental Surgery, focusing on the optimization of out-of-body heart perfusion. Mitchell’s main research interest is on strategies that improve donated organs through ex-situ heart perfusion apparati, however has also been involved in clinical research within the areas of radiology, respiratory medicine, and cardiology. Mitchell is the recipient of multiple prestigious awards such as the Canada Graduate Scholarship – Masters and the Cote Biomedical Research Studentship. As an aspiring surgeon-scientist, he intends on completing an MD/PhD program focusing to further improve out of body heart perfusion protocols.
Sarjana Alam is an undergraduate science student at the University of Alberta, where she is a research trainee under the supervision of Dr. Esme Dijke in the Department of Laboratory Medicine & Pathology. She is involved in a project investigating the cryopreservation of T regulatory cells for tolerogenic cell therapy.
Marie-Pier joined Dre. Marie-Josée Hébert’s lab in the nephrology, transplantation and renal regeneration research unit at the CRCHUM in 2024. She obtained her BSc degree in biology at McGill university and is now pursuing a Masters degree in the Molecular Biology program at l’Université de Montréal. She is currently working on evaluating the pro-angiogenic potential of RNAs enriched in apoptotic exosomes and whether these RNAs cooperate to modulate endothelial function. Marie-Pier is also a trainee in the Canadian Donation and Transplantation Research program (CDTRP).Outside of the lab, Marie-Pier loves to read, go to spin classes and play word games like Scattegories and Bananagrams.
Dr. Andreas Kramer is a Clinical Associate Professor in the Departments of Critical Care Medicine and Clinical Neurosciences. He graduated from medical school at the University of Manitoba in 1997 and received specialty training in internal medicine and critical care at the University of Calgary in 2002. After working for three years as a community internist and intensivist in Manitoba, he obtained fellowship training in neurocritical care at the University of Virginia 2005-2007. During this time, he also completed a Master of Science degree in Health Evaluation Sciences. Dr. Kramer joined the Department of Critical Care Medicine in Calgary in 2007. He has a particular research and clinical interest in neuro-monitoring and prevention of secondary brain injury in neurocritical care patients. Dr. Kramer is on the Editorial Boards of the journals Neurocritical Care and Critical Care Medicine. He has over 90 peer-reviewed publications, with about half of these as first or senior author. He is a co-investigator in a number of CIHR-sponsored clinical trials. Dr. Kramer has written multiple textbook chapters on a variety of neurocritical care topics, and was the co-editor of two 2017 neurocritical care editions of the Handbook in Clinical Neurology. Since 2011, he has been the Medical Director of the Southern Alberta Organ and Tissue Donation Program, and serves on numerous Canadian Blood Services advisory committees. Dr. Kramer is married with four very energetic children between the ages of 9 and 17.
Dr. Mypinder Sekhon is an intensivist and clinician-scientist in the intensive care unit at Vancouver General Hospital. He completed his medical school training, internal medicine residency and critical care medicine subspecialty fellowship at the University of British Columbia prior to completing a neurocritical care fellowship at Addenbrooke’s Hospital at the University of Cambridge, United Kingdom under the guidance of Professors David Menon and Arun Gupta. Subsequently, he completed is PhD in neurovascular sciences under Professor Philip Ainslie, a Canada Research Chair in cerebrovascular physiology. His clinical and research interests include multimodal neuromonitoring, cerebral autoregulation disturbance after brain injury and critical care management of severe acute brain injury patients.
My name is Matthew Kolisnyk. I am a third-year PhD Candidate in Neuroscience at Western University. My undergraduate training was in Psychology and Statistics, where I spent time applying neuroimaging techniques to memory and mindfulness research. In my current lab, I use neuroimaging to measure residual cognitive function in patients who have sustained an acute brain injury and use that neural measure in combination with machine learning to try and predict which patients will survive their injury. I currently am a research associate at the London Health Science Centre, where we measure physiological and neural changes that occur when patients undergo planned withdrawal of life-sustaining measures.
Jordan is a PhD student at UBC working in the Vancouver General Hospital ICU. His current work focuses on donation after circulatory death by looking at how the brain responds during the dying process after withdrawal of life-sustaining measures. During Jordan’s undergraduate degree in Health Sciences and Physics, he got his start in research focusing on whole body hypoxia in the context of high altitude physiology. This led to working in industry since 2020 using medical imaging to evaluate hypoxia and ischemia in wound care, vascular surgery, and plastic and reconstructive surgery. Jordan returned to school in 2021 to pursue a MSc with Dr. Glen Foster at UBCO focusing on developing and validating a new medical imaging approach to quantify diaphragm blood flow in humans. In 2023, Jordan joined the ICU Research Group to continue looking at oxygenation and blood flow in critically ill patients. As such, the unifying theme of Jordan’s work involves investigating low oxygen and blood flow in both healthy and clinical populations. This focus on physiology underpins the organ procurement process in donation after circulatory death as warm ischemic times may render organs ineligible for transplantation. Outside of research, Jordan can be found playing hockey, biking, running, reading, or trying to spend as much time outdoors in Alberta or British Columbia.
Hayden John is a student researcher passionate about addressing health inequities through patient and community-centred research. He has recently completed the Queen’s Accelerated Route to Medical School (QuARMS) pathway and is a first-year medical student at Queen’s University. Currently, he is a research student with the Kidney Health Education Research Group (KHERG) focusing on the A.C.TI.O.N Project: Improving Access to Living Donor Kidney Transplantation (LDKT) in Ethno-racial Minority Communities in Canada. Under the supervision of Principal Investigator Dr. Istvan Mucsi, Hayden explored the perceived risks and benefits of kidney donation among African, Caribbean and Black Canadians.
Meghan He is a UBC medical student who studied Comparative Literature and Psychobiology at UCLA. Her research focuses on grounding medicine in the humanity of patient stories. She is co-President of the UBC Surgical Club, where she co-founded the EDI advocacy group, UpSurge, in alliance in the UBC Department of Surgery. In her free time, she teaches kids’ yoga with the Vancouver School Board and volunteers for community dance events.
Dr. David Nicholas is a Professor and Associate Dean, Research and Partnerships in the Faculty of Social Work at the University of Calgary. He is the author of over 200 peer-reviewed research publications addressing topics such as wellbeing and transition to adulthood in chronic health conditions, including kidney disease. Dr. Nicholas’ research further focuses on capacity development in service delivery as well as navigation support for individuals with chronic health issues and disability, and their families. Dr. Nicholas has been the principal investigator on multiple grants from provincial, federal and international sources. He also brings clinical experience as a former nephrology social worker.
Sarah Pol is a Clinical Research Project Manager in the Anthony Lab at The Hospital for Sick Children (SickKids). She completed her undergraduate training in Health Sciences, Anthropology and Community Development at Western University, received a Master of Science in Global Health from McMaster University and pursued further training in Project Management at the University of Toronto. She is the User Experience and Implementation Lead for Voxe, an innovative, child- and healthcare provider-friendly, electronic patient-reported outcome measures (ePROM) platform for data capture and visualization. She is intricately involved in the SickKids Mental Health Measurement-Based Care (MBC) initiative’s clinical implementation of Voxe. Sarah is passionate about equity-oriented health research, the use of qualitative methods to amplify patients’ voices, artificial intelligence, and the meaningful integration of ePROMs into clinical practice to support MBC.
Jia Lin, MPH, is a Clinical Research Project Coordinator working alongside Dr. Samantha Anthony, a Health Clinician Scientist, in the Child Health Evaluative Sciences program at The Hospital for Sick Children in Toronto. The Anthony Lab examines the biopsychosocial impact of pediatric chronic illness on patients and families, with a focus on patient engagement, patient-reported outcome measures, implementation science, and mixed methods. In her role, Jia leads multiple clinical research studies across the research pipeline, including a current multi-phase, cross-Canada study exploring the experiences of Indigenous children and families who have received a solid organ transplantation. Rooted in patient and community engagement, this research employs storytelling to consider the multiplicity of knowledge, including Indigenous Knowledge, to advance child health equity. Jia recently began her PhD at McGill University with research interests at the nexus of equity-oriented, patient-engaged health research and applying critical qualitative approaches to amplify patients’ voices.
I obtained my PharmD from the University of Montreal, where I developed a strong foundation in pharmacotherapy. Eager to deepen my expertise, I completed a master’s in advanced pharmacotherapy, which enabled me to become a hospital pharmacist. For several years, I specialized as a cardiology and heart failure pharmacist, gaining invaluable experience in managing complex patient needs. Driven by a desire to expand my clinical skills, I pursued a medical degree, graduating with my MD from the University of Montreal in 2021 and earning a place on the Dean’s List. Following this achievement, I completed my training in internal medicine, and as of July 2024, I am currently in a cardiology residency at the University of Montreal. My primary interests lie in advanced heart failure and heart transplantation, areas in which I am actively involved in research with the advanced heart failure and heart transplant team at the Montreal Heart Institute. My background in pharmacy and medicine uniquely positions me to contribute to the evolving field of heart transplantation.
Ikram Abow-Mohamed is a PGY-3 Internal Medicine resident at McGill University, set to begin a Gastroenterology fellowship at McGill in the upcoming year.
Eva Amzallag holds a master’s degree in anthropology (2018) and a master’s degree in epidemiology (2024), both from Université de Montréal. Currently pursuing a PhD in epidemiology, her research interests include liver transplantation, transfusional medicine, and postoperative complications. Under the supervision of Dr. François Martin Carrier, anesthesiologist at the Centre hospitalier de l’Université de Montréal and CDTRP Investigator, her work explores the relationship between blood transfusions and postoperative pulmonary complications in liver transplant recipients.
Vanessa is a PhD-nurse, and a former Organ Donation Coordinator who has been devoted to research and active involvement in Organ Donation and Transplantation activities for over 10 years. Her research expertise is focused in quality improvement of organ donation programs and structures worldwide. She was a Kidney Research Scientist Core Education Program (KRESCENT) fellow and a Canadian Donation and Transplantation Research Program (CDTRP) trainee. She currently co-leads two groups within the CDTRP structure: Theme 1 “Improve the Culture of Donation” and the Allied Research in Donation and Transplantation (ARDOT) working group. She is currently an Assistant Professor at Brock University, and lead the investigation of burnout among donation coordinators, with the support and collaboration of Canadian Blood Services and key organ donation researchers nationally and internationally.
Dr. Somaya Zahran is currently a Nephrology fellow at McGill University and serves as a Chief fellow in the program. She earned her medical degree from Egypt and completed her PhD at the University of Alberta before pursuing internal medicine residency and nephrology fellowship at McGill University. Dr. Zahran is an AJKD editorial intern and a trainee member of the Canadian Society of Nephrology Clinical Practice Guideline Committee. She is looking forward to starting her Transplant fellowship at Mayo Clinic, Rochester in Jul 2025. Outside of her academic pursuits, Somaya loves spending time with her family and getting creative in the kitchen—she’s on a mission to find the perfect balance between kidney health and decadent desserts!