Ce qui suit est un bref résumé des lignes directrices compilées à partir des recommandations en don et transplantation accessibles publiquement et compilées en partenariat avec la Société Canadienne du Sang (SCS), la Société Canadienne de Transplantation (SCT) et le Programme de Recherche en Don et Transplantation du Canada (PRDTC). Les recommandations varient de sociétés internationales telles que The Transplantation Society à des organismes nationaux. Les informations seront mises à jour régulièrement selon les nouvelles recommandations ou les révisions disponibles.
Il ne s’agit pas d’un échantillon complet de tous les groupes qui ont formulé des recommandations liées à la COVID-19. Les premiers documents analysés comprennent l’information qui a été rassemblée sur le site Web de The Transplantation Society au moment de l’exercice. D’autres révisions de ces résumés incluront des documents et des recommandations d’autres groupes à mesure qu’ils seront disponibles et basés sur les commentaires de la communauté en don et transplantation.
Les déclarations résumées ci-dessous sont des opinions d’experts et/ou des déclarations/recommandations consensuelles publiées par divers individus ou sociétés, à l’échelle internationale. Les déclarations préliminaires relatives à la transplantation dans le cadre de la COVID-19 ont été systématiquement recherchées. Les déclarations résumées ne sont pas nécessairement basées sur des preuves empiriques, ni sur les valeurs et les préférences du patient. Veuillez noter qu’aucune de ces recommandations n’est destinée à servir de recommandations officielles aux professionnels de la santé et aux décideurs endossés par le Programme de Recherche en Don et Transplantation du Canada.
Bien que nous reconnaissions la distinction entre le pathogène viral SARS-CoV-2 et la COVID-19, la maladie causée par le virus, dans un souci de simplicité et de lisibilité, nous nous référerons principalement à la COVID-19. Par exemple, lors du dépistage de donneurs potentiels, nous indiquerons que nous effectuons un dépistage de la COVID-19, sachant que les tests sont conçus pour détecter la présence du SARS-CoV-2.
Terminologie abrégée utilisée : Y (Yes, pour indiquer des recommandations) / N (No, pour indiquer non-recommandé) / NR (Aucune recommandation, pour indiquer qu’aucune recommandation n’a été proposée par l’établissement). Cliquez sur les lettres soulignées pour afficher les recommandations.
Un merci spécial à : Matthew Weiss, Allison Mah, 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 et Hyunyun Kim.
À noter que tous les documents sont en anglais.
Dernière mise à jour : 27 octobre 2020
Sélection COVID-19 des donneurs décédés potentiels
Tests et dépistage pour tous les patients qui sont des donneurs potentiels?
Il y a eu un large consensus sur le fait que tous les patients qui sont des donneurs décédés potentiels devraient subir une forme quelconque de test ou de dépistage COVID-19. Il a été universellement sous-entendu ou explicitement déclaré que la sélection des donneurs devrait inclure des questions sur les symptômes cliniques et le risque d’exposition. La manière d’interpréter ces questions de dépistage varie, avec une grande variabilité concernant la définition du risque intermédiaire ou élevé sur la base des questions de dépistage. Certains groupes ont également déclaré que des résultats de laboratoire négatifs n’excluent pas la nécessité de procéder à des interrogatoires détaillés pour tous les patients afin d’évaluer le risque potentiel. En ce qui concerne les tests de laboratoire, presque tous les groupes ont recommandé un dépistage de routine en laboratoire de tous les patients qui étaient des donneurs potentiels. L’exception provenait principalement d’organisations qui ont publié des recommandations au début de l’épidémie et qui ont fait la distinction entre les zones où les taux de transmission sont élevés et celles où ils sont faibles. Pour ces organisations, elles mentionnent qu’il peut être possible de ne tester que les patients dont le risque est jugé élevé sur la base de questions liées à l’historique des symptômes ou au risque d’exposition, en particulier si l’accès aux tests de laboratoire est limité.
| 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/ |
Test PCR sur écouvillon nasopharyngique (réaction en chaîne de la polymérase) (colonne 1)
La plupart des organisations ont préféré la technique de PCR nasopharyngique (NP). Dans la plupart des régions, c’est le test le plus couramment effectué et probablement le plus facilement disponible. Les préoccupations concernant la sensibilité, en particulier les premiers rapports sur les taux élevés de faux négatifs, ont amené certains groupes à recommander d’autres tests de dépistage en plus des écouvillons NP, mais aucun groupe n’a recommandé de s’y opposer.
Test PCR sur écouvillon oropharyngique (réaction en chaîne de la polymérase) (colonne 2)
Les groupes ont également fréquemment recommandé des prélèvements PCR oropharyngiques (OP), souvent en remplacement des prélèvements NP. La plupart des groupes n’ont pas fait de distinction entre les écouvillons NP ou OP. Seules les recommandations canadiennes communes ont spécifiquement déconseillé l’utilisation de prélèvements OP, principalement en raison de la facilité de normalisation des techniques par l’opérateur et de l’amélioration de la tolérance du patient.
Utilisation préférentielle de la sécrétion bronchique pour le test PCR (colonne 3)
Certains groupes recommandent des tests de sécrétion bronchique en raison d’une sensibilité accrue suspectée, mais avec des réserves. La première est que la collecte d’échantillons par lavage bronchoalvéolaire (LBA) augmente le risque de production d’aérosols et donc de propagation du virus s’il est présent. Plusieurs groupes ont averti que si le LBA est choisi, il doit être effectué conformément aux directives locales en matière d’infection afin de limiter la génération et la propagation d’aérosols. Sinon, les sécrétions bronchiques pourraient être collectées à l’aide de techniques telles que l’aspiration en ligne par coin qui réduirait ou éliminerait le risque d’aérosols. Aucun organisme n’a cité de preuves suggérant que l’une de ces méthodes de collecte des sécrétions bronchiques a démontré une meilleure sensibilité ou spécificité.
Tomographie thoracique informatisée (CT) chez les donneurs potentiels asymptomatiques (colonne 5)
La plupart des groupes n’ont formulé aucune recommandation concernant l’utilisation du scanner chez les patients asymptomatiques, seules la Belgian Transplantation Society et l’International Society of Heart and Lung Transplantation recommandant leur utilisation en routine. La justification était la possibilité de découvrir des preuves radiologiques de COVID-19 avant le développement des symptômes dans cette population. Aucun organisme n’a recommandé de s’opposer à ce type de dépistage. Aucun groupe n’a cité de preuves suggérant que cette application du dépistage par tomodensitométrie était efficace pour diagnostiquer la COVID-19 chez les patients dont le test PCR était négatif.
Utilisation des tests sanguins (colonne 6)
Aucun groupe ne recommande l’utilisation actuelle des analyses sanguines (tests d’anticorps ou sérologie) pour la prise de décision clinique. L’ONT en Espagne a spécifiquement recommandé de ne pas utiliser ces tests sanguins en attendant de mieux comprendre leur utilité. Toutefois, plusieurs groupes, dont le NHSBT au Royaume-Uni et les recommandations conjointes de l’Australie et de la Nouvelle-Zélande, recommandent de conserver le sang ou le sérum pour de futurs tests rétrospectifs à mesure que ceux-ci seront plus largement disponibles et compris.
Tests ou procédures améliorés pour les donneurs potentiels « à risque » (par exemple, antécédents de voyage ou symptômes) (colonne 4)
Certains groupes ont recommandé que les patients qui sont identifiés comme étant à haut risque, soit par un examen de leurs symptômes, soit par un risque de contact potentiel, subissent des tests supplémentaires. Cela inclut l’exigence d’au moins deux tests négatifs pour les patients à haut risque (recommandations conjointes canadiennes) ou l’exigence d’un test de sécrétion de LBA (Société européenne de transplantation). Les échantillons de sang des patients considérés comme présentant un risque intermédiaire ou élevé ont également été recommandés par le Réseau américain pour le partage d’organes (UNOS). On a constaté une grande variabilité tant dans les tests de suivi de ces populations « à risque » que dans les populations considérées comme « à risque ».
| 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/ |
Exclure les donneurs ayant une infection à la COVID-19 documentée? (colonne 1)
Au moment de cette enquête de recommandations, le seul groupe qui n’excluait pas catégoriquement les patients présentant une infection à la COVID-19 documentée était l’Agence Biomédicale en France. Dans cette première, ils recommandent que dans le cas d’une transplantation permettant de sauver une vie – par exemple pour un receveur en phase terminale d’insuffisance cardiaque et non éligible pour un dispositif mécanique – les risques et les avantages soient soigneusement examinés entre le patient qui est un receveur potentiel et l’équipe de traitement. Ils ont également exclu le don de patients souffrant d’une infection « non contrôlée ». Tous les autres groupes ont explicitement ou implicitement exclu le don des donneurs COVID-19 +.
Exclure les donneurs dont le dépistage COVID-19 n’est pas concluant? (colonne 2)
Trois organisations sélectionnées ont fait remarquer que les patients dont les tests ne sont pas concluants devraient également être exclus comme donneurs potentiels dans certaines circonstances. Par exemple, l’UNOS aux États-Unis recommande que si un patient est jugé à « risque intermédiaire » et qu’aucun test n’est disponible, ce patient ne devrait pas être considéré comme un donneur. De même, l’Organización Nacional de Trasplantes (ONT) en Espagne recommande l’exclusion des patients dont les résultats des tests ou du dépistage clinique sont indéterminés.
| 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/ |
Si la plupart des groupes ont recommandé un dépistage en laboratoire des patients qui sont des donneurs potentiels, comme indiqué ci-dessus, certains ont également recommandé d’exclure les patients sur la base de certains critères cliniques ou de risque d’exposition, indépendamment des résultats de laboratoire. Par exemple, la recommandation conjointe de l’Australie et de la Nouvelle-Zélande était l’un des sept groupes à énoncer quelque chose de similaire : « les patients atteints de pneumonie communautaire bilatérale grave devraient être exclus, quels que soient les résultats du dépistage. »
| 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/ |
Trois des groupes ont commenté l’acceptation des organes d’autres pays. Au début de l’épidémie, le groupe canadien s’est inquiété du fait que seuls les organes provenant de programmes ayant un accès adéquat à la sélection des donneurs devraient être acceptés. Aucun groupe n’a exclu catégoriquement l’acceptation d’offres internationales, mais a déclaré que ces offres devraient être examinées en fonction de l’épidémiologie du lieu d’offre, en consultation avec la direction médicale de l’organisation de don d’organes (ODO).
| 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/ |
Bien que plusieurs groupes aient recommandé des protocoles ou des algorithmes pour déterminer quand un patient dont la COVID-19 avait été confirmée précédemment pouvait être considéré comme un donneur potentiel, les détails de ces algorithmes variaient considérablement. Les périodes d’attente après la résolution des symptômes variaient de 14 à 28 jours. La plupart des groupes, mais pas tous, ont recommandé spécifiquement de répéter les tests après la résolution des symptômes, certains nécessitant un seul test négatif et d’autres deux tests. Il sera de plus en plus important d’apporter des éclaircissements dans ce domaine à mesure que l’incidence de la COVID-19 augmentera et que de plus en plus de patients ayant des antécédents récents de COVID-19 deviendront des donneurs potentiels en raison de maladies ou de blessures sans rapport avec la maladie.
| 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/ |
Une seule organisation, l’International Liver Transplant Society, a spécifiquement recommandé d’éviter la récupération d’organes de donneurs dans les zones endémiques ou à forte prévalence. Les autres organisations interrogées n’ont fait aucune mention de cette question.
| 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/ |
Évaluation de l’exposition et recommandations pour la sélection des receveurs
Les sociétés recommandent généralement que les receveurs potentiels de dons d’organes subissent un test TAN symptomatique et viral avant la transplantation. Peu de sociétés font des commentaires sur l’utilisation de l’imagerie thoracique par tomodensitométrie chez les donneurs potentiels pour évaluer les résultats de la COVID-19 et dans celles qui le font, elles recommandent ou recommandent conditionnellement que cette modalité puisse être utilisée.
Les sociétés internationales n’abordent pas spécifiquement les mesures de test ou d’évaluation renforcées pour les donneurs potentiels ayant des contacts positifs connus et récents avec la COVID-19. Si les donneurs ont un contact positif récent avec la COVID-19, il est recommandé d’isoler ces donneurs pendant 14 jours à compter du dernier 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/ |
Pour les candidats à la transplantation qui ont récemment voyagé, il est recommandé de prévoir un délai de 14 jours à compter du retour du voyage avant de considérer la transplantation comme admissible. Si un candidat à la transplantation développe la COVID-19, les sociétés recommandent la résolution des symptômes, au moins deux tests NAT viraux négatifs et un délai de 14 jours avant de considérer la transplantation comme éligible. Peu de sociétés commentent la possibilité d’une transplantation pulmonaire chez les personnes souffrant d’une maladie pulmonaire grave liée à la COVID-19 et recommandent une approche prudente et limitée.
| 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/ |
Risques post-transplantation
Il existe peu d’indications concernant la thérapie d’épuisement des lymphocytes, les sociétés qui s’occupent de cette question suggérant de réduire l’utilisation de cette thérapie pendant la pandémie. En ce qui concerne l’immunosuppression, la recommandation générale qui ressort des orientations disponibles est de ne pas réduire l’immunosuppression chez les receveurs de greffe asymptomatiques. Dans le cas des receveurs atteints de la COVID-19, il est recommandé d’envisager une réduction de l’immunosuppression, la plupart des sociétés suggérant de commencer par l’ajustement à l’antimétabolite. Cette décision doit être prise en collaboration avec l’équipe de transplantation et ne doit pas être prise en charge par les receveurs eux-mêmes.
Les sociétés ne font pas de commentaires ou de recommandations contre le traitement prophylactique anti-SARS-CoV-2 pour le moment. En ce qui concerne les antiviraux thérapeutiques, le NHS recommande une utilisation potentielle dans le cadre d’un essai clinique, tandis que l’AASLD recommande l’utilisation du Remdésivir. En raison de considérations liées aux interactions médicamenteuses, le Lopinavir/Ritonavir n’a pas la faveur de l’UNOS chez les greffés.
| 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/ |
Bien que plusieurs sociétés indiquent qu’il pourrait y avoir un risque accru d’infection par le SARS-CoV-2 ou une autre maladie grave, cela est toutefois largement inconnu. Les recommandations fournies sur la prise en charge des receveurs de greffe pour réduire le risque d’acquisition de la maladie sont conformes aux recommandations locales de santé publique et comprennent une recommandation d’isolement après un voyage international et de suivre les conseils de santé publique concernant l’hygiène des mains et la distanciation sociale. En ce qui concerne le port du couvre-visage, certaines juridictions le recommandent pour tous les individus lorsqu’ils sont en public, ce qui s’applique également aux receveurs de greffes. Le couvre-visage est particulièrement recommandé pour tout receveur de transplantation symptomatique et doit être porté pendant l’évaluation pour la 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/ |
Les recommandations des sociétés s’entendent sur la prévention et le contrôle des infections hospitalières ainsi que sur les recommandations de santé publique, selon lesquelles les patients positifs pour la COVID-19 doivent être séparés géographiquement des services de transplantation et que la santé publique doit être alertée pour tout patient suspecté pour la COVID-19. Dans un effort de minimiser la transmission, plusieurs sociétés recommandent de limiter les rendez-vous cliniques et diagnostiques non essentiels ainsi que de limiter les visiteurs. Les transplantés présentant de la fièvre ou des symptômes respiratoires ou gastro-intestinaux doivent informer leur équipe de transplantation.
| 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/ |
Recommandations pour les dons de personnes décédées
Lorsqu’ils ont examiné les risques entre la transplantation et l’immunosuppression pendant une pandémie alors que les délais d’attente pour la transplantation sont prolongés dû à la suspension temporaire des programmes, les groupes ont fait la distinction entre les formes de transplantation vitales et non vitales. Le mot d’ordre était que si les patients inscrits sur la liste d’attente pouvaient être soutenus pendant la durée de la pandémie – en prolongeant la dialyse par exemple – le programme serait alors suspendu, mais que les transplantations plus urgentes – insuffisance cardiaque ou hépatique en phase terminale par exemple – devraient être envisagées au cas par cas.
Il y a une certaine variabilité internationale quant à savoir si les programmes de dons de reins et de pancréas de personnes décédées devaient être suspendus entièrement ou continuer avec des opérations modifiées. Certains pays, dont le Canada et les Pays-Bas, ont recommandé l’arrêt complet, tandis que d’autres, comme l’Espagne et le Royaume-Uni, ont recommandé une diminution des opérations à évaluer au cas par cas. Certains groupes internationaux tels que The Transplant Society (TTS), ont recommandé d’envisager la suspension des dons de personnes décédées dans les pays où la transmission communautaire est répandue. De multiples facteurs ont conduit à la suspension ou à la diminution du niveau des activités, notamment le risque d’exposition du receveur après la transplantation, le risque inconnu de transmission de donneur à receveur (bien qu’il ne soit pas signalé actuellement) et les ressources limitées des unités de soins intensifs pour maintenir les patients qui sont des donneurs potentiels ou traiter les complications post-opératoires chez les receveurs. La plupart ont recommandé une évaluation continue de l’état de ces facteurs afin de réactiver les systèmes à leur pleine capacité le plus rapidement possible pour éviter tout préjudice inutile aux patients en attente d’une transplantation.
| 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/ |
Alors que plusieurs groupes ont recommandé la modification des programmes de transplantation de foie de donneurs décédés, aucun groupe n’a recommandé la suspension complète de toute activité. Ainsi, les groupes ont encouragé les programmes à être de plus en plus sélectifs tant pour les donneurs que pour les receveurs, et il a été recommandé de poursuivre les dons vitaux au cas par cas.
| 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/ |
Alors que plusieurs groupes ont recommandé la modification des programmes de transplantation cardiaque ou pulmonaire de donneurs décédés, aucun groupe n’a recommandé la suspension complète de toute activité. Ainsi, les groupes ont encouragé les programmes à être de plus en plus sélectifs tant pour les donneurs que pour les receveurs, le don vital étant recommandé de continuer au cas par cas. The International Society of Heart and Lung Transplantation a spécifiquement recommandé de ne pas suspendre de manière générale les programmes de transplantation d’organes thoraciques en raison de leur caractère vital. Plusieurs groupes ont souligné le risque particulièrement accru des receveurs de poumons s’ils devaient être infectés par la COVID-19 après la transplantation, mais ont également conclu qu’il peut y avoir des circonstances d’insuffisance respiratoire terminale qui justifieraient le risque de transplantation même dans le cadre d’une pandémie avec une propagation communautaire importante.
| 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/ |
Don vivant / Recommandations pour les dons jumelés
La majorité des orientations internationales recommandent que les programmes suspendent les dons vivants de reins et de foie ainsi que les programmes de dons jumelés de reins. Si ces programmes ou les transplantations individuelles se poursuivent, il est uniformément recommandé que les donneurs vivants potentiels prennent toutes les mesures nécessaires pour limiter l’exposition à la COVID-19 , y compris l’exclusion du don et l’auto-isolement pendant 14 à 21 jours après un voyage international et des mesures strictes de distanciation sociale dans les 14 jours précédant la transplantation. La majorité des groupes recommandent un dépistage des symptômes et un test d’acide nucléique viral (ANV) chez les donneurs vivants. Il existe peu de recommandations concernant la prise en charge des donneurs vivants ayant des antécédents de COVID-19 résolus, les sociétés qui s’occupent de cette question recommandant au moins deux tests ANV négatifs avant le don.
| 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/ |
Utilisation de l’équipement de protection individuelle (EPI) par les professionnels du don et de la transplantation d’organes
Utilisation courante (colonnes 3 et 5)
La plupart des groupes ont émis des recommandations concernant l’utilisation des EPI. Le plus souvent, ils ont encouragé le respect des pratiques nationales et locales concernant les types d’EPI utilisés dans différentes situations. Certains ont spécifiquement indiqué que des EPI complets et adéquats doivent être mis à la disposition des professionnels du don et de la transplantation (ODT), soit par l’intermédiaire de l’organisation de don d’organes associée (ODO), soit par le système hospitalier. Quelques organisations ont recommandé l’utilisation systématique des précautions universelles (masque chirurgical et gants) pour toutes les rencontres avec les patients, indépendamment des recommandations locales.
Exigences en matière d’EPI pour les professionnels de l’ODT lors de procédures susceptibles de provoquer des aérosols (par exemple, bronchoscopie ou extubation dans la salle d’opération) (colonne 4)
Certains groupes mentionnent spécifiquement les précautions de transmission par voie aérienne et la nécessité de veiller à ce que les professionnels de l’ODT aient accès aux équipements appropriés – en particulier aux masques N95 – s’ils sont présents lors de ces procédures.
Recommandations aux professionnels de l’ODT suite à un contact avec des patients confirmés ou suspectés d’être atteints de la COVID-19 (colonne 2)
Les groupes qui se sont exprimés sur cette question ont généralement recommandé que le personnel de l’ODT suive les recommandations existantes pour les autres professionnels de la santé après une exposition confirmée ou potentielle à la COVID-19.
Modification de la routine du personnel pour diminuer la transmission (colonnes 5 et 6)
Plusieurs groupes recommandent que les ODO modifient leurs habitudes pour encourager autant que possible la distanciation sociale. Les moyens suggérés comprennent l’encouragement de la vidéoconférence, la limitation des déplacements du personnel entre les hôpitaux lorsque cela est possible, et le respect des protocoles de distanciation sociale dans les bureaux ou les installations des ODO. Un groupe a mentionné qu’il faudrait prendre en considération le personnel présentant des facteurs de risque sous-jacents pour la gravité de la maladie (par exemple, immunosuppression, âge avancé) afin d’éviter une présence inutile dans les hôpitaux ou un contact direct avec les patients.
| 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/ |
Recommandations supplémentaires
Nécessité d’informer les receveurs potentiels sur les questions relatives au risque d’infection par la COVID-19 ou à la nécessité d’un isolement renforcé après la transplantation (colonne 1)
De nombreux groupes ont recommandé que si une transplantation était jugée médicalement nécessaire pendant la pandémie, les receveurs potentiels devraient être clairement informés des risques potentiels supplémentaires d’infection par la COVID-19 après la transplantation et qu’un isolement strict et prolongé serait probablement nécessaire. Pour les quelques programmes qui recommandaient d’autoriser la transplantation à partir de donneurs positifs à la COVID-19 ou indéterminés, la plupart ont déclaré que les exigences en matière de consentement étaient assez élevées, y compris une explication du manque de connaissances concernant le risque potentiel de transmission ou les conséquences si la transmission se produisait.
Examen de l’équilibre entre la libération des ressources de l’unité de soins intensifs (USI) par une transplantation réussie et les besoins de l’USI après la transplantation (colonne 2)
Presque tous les groupes ont reconnu que la pandémie pourrait créer une demande accrue de ressources pour les soins intensifs, ce qui mettrait à rude épreuve la capacité d’un hôpital à prendre en charge les patients qui sont des donneurs ou des receveurs potentiels nécessitant une greffe dans l’unité de soins intensifs. Toutefois, certains groupes ont mentionné que la nécessité de limiter la charge excessive sur le système par le biais des dons et des transplantations doit être balancé avec la possibilité de libérer les ressources des USI par le biais des transplantations. Ils affirment que la transplantation d’un patient hospitalisé dans l’USI pour une insuffisance hépatique ou cardiaque terminale pourrait en fait réduire la charge globale du système en permettant le transfert de ce patient dans le service. Tous les groupes ont pris soin de préciser que ces décisions doivent être prises en tenant compte des conditions actuelles de l’ensemble du système de santé et qu’il ne serait pas possible de formuler des recommandations générales applicables à tous les cas.
Le risque de la transplantation peut l’emporter sur les avantages
Plusieurs groupes de transplantation ont déclaré que si les avantages médicaux et sociétaux de la transplantation en temps ordinaire sont clairs, la transplantation d’un patient ayant accès à une thérapie efficace de remplacement d’organe (par exemple la dialyse) ne serait pas recommandée tant que l’on ne connaîtrait pas mieux le risque d’acquisition de la COVID-19 après la transplantation et le pronostic des receveurs de greffe immunosupprimés.
| 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/ |
S’assurer que le receveur et l’équipement sont disponibles pour les organes avant l’initiation (colonnes 1 et 4)
Compte tenu de la diminution des ressources disponibles, en particulier au cours des premiers stades de la pandémie, deux groupes ont explicitement recommandé que les programmes de transplantation des ODO veillent à ce qu’il y ait des receveurs potentiels qui soient médicalement admissibles et disposés à recevoir l’organe avant d’engager des ressources dans le processus de don. Cette recommandation reconnaît qu’il serait déconseillé, dans un contexte de ressources limitées, d’engager des ressources des USI ou des ODO pour des cas peu susceptibles de donner lieu à un don et à une transplantation réels. Un groupe a également mentionné la disponibilité des équipements de protection individuelle pour le personnel d’ODO avant le début du processus.
Équipe locale de récupération et d’expédition des organes (colonne 1)
Trois organisations ont recommandé que dans le cas où le donneur et le receveur se trouvent dans des lieux géographiques différents, le prélèvement soit effectué par des équipes locales chaque fois que cela est possible et que l’organe soit expédié afin de limiter les déplacements des équipes de prélèvement.
Transplantation dans un établissement désigné non COVID-19 avec une exposition limitée aux patients COVID-19 potentiels (colonnes 2 et 6)
Bien qu’ils ne soient pas disponibles dans tous les systèmes, deux groupes ont recommandé que, lorsque cela est possible, la transplantation et les soins ultérieurs aient lieu dans des établissements ou des sections d’un hôpital qui sont désignés comme exemptes de cas de COVID-19 et capables d’admettre uniquement des patients dont la présence de COVID-19 est confirmée ou suspectée. Deux groupes ont spécifiquement mentionné que les patients devraient être séparés des patients ayant un dépistage COVID-19 même indéterminé.
Diminution de la nécessité d’établir des rapports de suivi post-transplantation ou de saisir des données (colonne 6)
Le réseau américain United Network for Organ Sharing (UNOS) a fait des recommandations pour réduire la nécessité de saisir les données post-transplantation dans son système, compte tenu de la diminution potentielle des effectifs ou des ressources. Ces recommandations étaient censées être temporaires et devraient être ajustées à mesure que les effectifs et les ressources reviennent à des niveaux normaux.
| 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/ |
Les recommandations internationales reconnaissent que les candidats à la transplantation inscrits sur la liste d’attente sont potentiellement plus exposés au risque de complications liées à la COVID-19 étant donné leur statut de maladie en phase terminale de l’organe et l’obligation de reporter la transplantation si un candidat à la transplantation est infecté. À cette fin, plusieurs sociétés recommandent que les personnes figurant sur la liste d’attente adhèrent à une distanciation sociale, y compris une éventuelle altération de la vie quotidienne et des conditions de travail, et que les visites en clinique soient limitées afin de réduire le risque d’exposition. Il existe un minimum d’orientations concernant le renforcement du dépistage et des tests chez les patients inscrits sur les listes d’attente. L’AASLD recommande un contrôle de la température lors de toutes les visites à la clinique.
| 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/ |
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.