Covid-19 no longer a barrier to organ donation, but here's what has changed
'Yes, people who have recovered from Covid-19 can safely donate organs,' says Dr. Ajeet Singh, Head of Critical Care Medicine at Aakash Healthcare. 'We have come a long way in understanding this virus and its effects. A donor who has recovered and tests negative poses no risk to the recipient.'A landmark study from Washington University School of Medicine in St. Louis, US, backs this up. It found that kidneys from donors who had previously tested positive for Covid were safe for transplantation, with no traces of the virus being passed from donor to recipient."As a physician, during the early part of Covid-19 pandemic, concerns led to exclusions of the fear of viral transmission of Covid to the recipients through organs, possibility of persistent infection even after recovery and interruptions in viability of organs by inflammation or damage. There was high risk in immunosuppressed recipients, and residuals could not be ruled out by limited testing. Safety issues regarding health care workers and the shortage of resources were other causes of blanket bans," Dr. Vikas Agarwal, Director and HOD, Robotic Urology, Aakash Healthcare, tells IndiaToday.in.But this notion changed. An analysis by the United Network for Organ Sharing (UNOS) found that organ transplants from donors who had tested positive for Covid-19 had similar graft survival rates to those from donors without the infection.In India, a multicentre study on 31 kidney transplants from living donors who had recovered from Covid-19 reported no virus transmission or unusual complications in recipients.Systematic reviews have confirmed the safety of using COVID-recovered donors, provided they test negative before the transplant. In the case of heart and lung transplants, short-term safety data is reassuring, and long-term outcomes are already being tracked.HOW THE PANDEMIC CHANGED ORGAN DONATION RULESDuring the peak of the pandemic, organ donation practices underwent a drastic shift. Many hospitals suspended donations from Covid-positive patients, and even those who had recovered, due to fear of possible transmission.'Initially, we were extremely cautious. Any donor with a Covid history was automatically ruled out,' says Dr. Rajiv Kumar Sethia, Director & Head of Urology, Kidney Transplant & Robotic Surgery at Asian Hospital.He adds, however, that that because research and "with all the safety checks we have in place today, organ donations from patients who have recovered from Covid-19 are completely safe.'advertisementHospitals now follow strict screening protocols to ensure donors are fully recovered and test negative before proceeding with a transplant.Current protocols require donors to undergo a SARS-CoV-2 PCR test using a nasopharyngeal swab, with a negative result obtained within three days before organ retrieval. Donors' symptoms, exposure history, and recovery from COVID-19 must also be carefully reviewed and documented.For immunosuppressed recipients, additional precautions are taken through universal microbiologic screening, including organ-specific tests such as bronchoalveolar lavage (BAL) for lung transplants.Doctors also check the donor's medical history, symptoms, and exposure to Covid, and make sure their recovery is well-documented."In high-risk cases, like for people with weakened immune systems, extra tests are done — including organ-specific checks such as a lung fluid test for lung transplants. In many cases, there is also a waiting period of 21 to 90 days after the donor's recovery before the transplant goes ahead," says Dr. Vikas Agarwal.Lungs and intestines, however, are bound to be more restrictive, as the risk of viral persistence is more. "For lung transplants, bronchoalveolar lavage (BAL) is required in addition to regular swab tests, and a delay of six to seven weeks after recovery is recommended," adds Dr. Agarwal.advertisementFor kidneys, liver, and heart transplants, standard negative PCR testing is generally sufficient, with fewer additional requirements.Corneal transplants have minimal restrictions unless there is systemic infection. These guidelines continue to be updated as new evidence emerges.INDIA'S ONGOING TRANSPLANT GAPWhile this scientific clarity is good news, India continues to face a deep mismatch between the number of organs needed and those available.The country performs the third-highest number of transplants in the world, after the US and China, but the per capita rate remains low.According to The Lancet Regional Health – Southeast Asia, more than 2 lakh people in India develop end-stage kidney failure each year. Yet only about 11,000 kidney transplants are carried out annually, leaving thousands dependent on dialysis or without any treatment.Dr. Ajeet points to two major challenges: the shortage of organ donors and the difficulty of transporting organs to rural and smaller towns in time.'Most transplants in India still happen in private hospitals. We need stronger public systems where more people can access transplants without worrying about costs," he says.THE CULTURAL AND AWARENESS BARRIEREven when organ donation is medically possible, many families hesitate to donate a loved one's organs after death. In this, usually religious beliefs, lack of awareness, and fear of the process are among the biggest hurdles.advertisement'People in small towns face a lot of hesitation when it comes to organ donations. We need better awareness and simpler legal procedures so that more people can come forward to donate," says Dr. Sunita Kapoor, Director & Laboratory Head at City X-ray Scan & Clinic.HOW TO LESSEN THE GAPTo bridge the gap between demand and availability, Dr. Sunita says that besides widespread awareness about the importance of deceased organ donation, we also need to simplifying the legal process for consenting to organ donation."Investing in public transplant infrastructure so that life-saving surgeries are not limited to those who can afford private care," she says.Although Covid-19 no longer stands in the way of safe organ donation, India still faces deep systemic, cultural, and logistical challenges in ensuring that life-saving organs reach the patients who need them most.- Ends
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When Covid-19 first gripped the world in early 2020, it brought a wave of uncertainty, not just about treatment and prevention, but about other critical areas of healthcare, including organ someone who had recovered from Covid safely donate a kidney or liver? Would traces of the virus still linger in their body and harm a transplant recipient?Five years on, medical experts say the answer is 'Yes, people who have recovered from Covid-19 can safely donate organs,' says Dr. Ajeet Singh, Head of Critical Care Medicine at Aakash Healthcare. 'We have come a long way in understanding this virus and its effects. A donor who has recovered and tests negative poses no risk to the recipient.'A landmark study from Washington University School of Medicine in St. Louis, US, backs this up. It found that kidneys from donors who had previously tested positive for Covid were safe for transplantation, with no traces of the virus being passed from donor to recipient."As a physician, during the early part of Covid-19 pandemic, concerns led to exclusions of the fear of viral transmission of Covid to the recipients through organs, possibility of persistent infection even after recovery and interruptions in viability of organs by inflammation or damage. There was high risk in immunosuppressed recipients, and residuals could not be ruled out by limited testing. Safety issues regarding health care workers and the shortage of resources were other causes of blanket bans," Dr. Vikas Agarwal, Director and HOD, Robotic Urology, Aakash Healthcare, tells this notion changed. An analysis by the United Network for Organ Sharing (UNOS) found that organ transplants from donors who had tested positive for Covid-19 had similar graft survival rates to those from donors without the India, a multicentre study on 31 kidney transplants from living donors who had recovered from Covid-19 reported no virus transmission or unusual complications in reviews have confirmed the safety of using COVID-recovered donors, provided they test negative before the transplant. In the case of heart and lung transplants, short-term safety data is reassuring, and long-term outcomes are already being THE PANDEMIC CHANGED ORGAN DONATION RULESDuring the peak of the pandemic, organ donation practices underwent a drastic shift. Many hospitals suspended donations from Covid-positive patients, and even those who had recovered, due to fear of possible transmission.'Initially, we were extremely cautious. Any donor with a Covid history was automatically ruled out,' says Dr. Rajiv Kumar Sethia, Director & Head of Urology, Kidney Transplant & Robotic Surgery at Asian adds, however, that that because research and "with all the safety checks we have in place today, organ donations from patients who have recovered from Covid-19 are completely safe.'advertisementHospitals now follow strict screening protocols to ensure donors are fully recovered and test negative before proceeding with a protocols require donors to undergo a SARS-CoV-2 PCR test using a nasopharyngeal swab, with a negative result obtained within three days before organ retrieval. Donors' symptoms, exposure history, and recovery from COVID-19 must also be carefully reviewed and immunosuppressed recipients, additional precautions are taken through universal microbiologic screening, including organ-specific tests such as bronchoalveolar lavage (BAL) for lung also check the donor's medical history, symptoms, and exposure to Covid, and make sure their recovery is well-documented."In high-risk cases, like for people with weakened immune systems, extra tests are done — including organ-specific checks such as a lung fluid test for lung transplants. In many cases, there is also a waiting period of 21 to 90 days after the donor's recovery before the transplant goes ahead," says Dr. Vikas and intestines, however, are bound to be more restrictive, as the risk of viral persistence is more. "For lung transplants, bronchoalveolar lavage (BAL) is required in addition to regular swab tests, and a delay of six to seven weeks after recovery is recommended," adds Dr. kidneys, liver, and heart transplants, standard negative PCR testing is generally sufficient, with fewer additional transplants have minimal restrictions unless there is systemic infection. These guidelines continue to be updated as new evidence ONGOING TRANSPLANT GAPWhile this scientific clarity is good news, India continues to face a deep mismatch between the number of organs needed and those country performs the third-highest number of transplants in the world, after the US and China, but the per capita rate remains to The Lancet Regional Health – Southeast Asia, more than 2 lakh people in India develop end-stage kidney failure each year. Yet only about 11,000 kidney transplants are carried out annually, leaving thousands dependent on dialysis or without any Ajeet points to two major challenges: the shortage of organ donors and the difficulty of transporting organs to rural and smaller towns in time.'Most transplants in India still happen in private hospitals. We need stronger public systems where more people can access transplants without worrying about costs," he CULTURAL AND AWARENESS BARRIEREven when organ donation is medically possible, many families hesitate to donate a loved one's organs after death. In this, usually religious beliefs, lack of awareness, and fear of the process are among the biggest in small towns face a lot of hesitation when it comes to organ donations. We need better awareness and simpler legal procedures so that more people can come forward to donate," says Dr. Sunita Kapoor, Director & Laboratory Head at City X-ray Scan & TO LESSEN THE GAPTo bridge the gap between demand and availability, Dr. Sunita says that besides widespread awareness about the importance of deceased organ donation, we also need to simplifying the legal process for consenting to organ donation."Investing in public transplant infrastructure so that life-saving surgeries are not limited to those who can afford private care," she Covid-19 no longer stands in the way of safe organ donation, India still faces deep systemic, cultural, and logistical challenges in ensuring that life-saving organs reach the patients who need them most.- Ends
