Publication date: Aug 21, 2024

Whether solid organ transplant (SOT) can be safely performed in recipients with ongoing SARS-CoV-2 infection is still a debated question. A systematic review of the literature on recipients with ongoing SARS-CoV-2 infection at the time of surgery and the associated outcomes. From 29 studies, we identified 54 recipients; their median age was 47. 5 years, and over half (23/54,54. 85%) were affected by fewer than two comorbidities. Kidney was the most common transplanted organ (24/54,44. 4%). SOT was performed without knowing the ongoing infection in 11. 1% (6/54) of patients. On average, 16. 1 (SD 23. 2) days elapsed between SARS-CoV-2 infection and SOT, with a mean Ct value at diagnosis and transplantation of 29 and 31. 9, respectively. Most patients (25/39,64. 1%) had received previous COVID-19 vaccinations. Twenty-four patients (45. 3%) received an anti-SARS-CoV-2 therapy. Ten patients (18. 5%) required oxygen support, while seven (13. 7%) were admitted to the intensive care unit. There were two reported cases (3. 7%) of all-cause death, while there were no cases of COVID-19-related death. Deliberate SOT of recipients with ongoing SARS-CoV-2 is performed worldwide in candidates of non-lung transplant who are fit, immunized against the virus, and displaying a non-severe disease course. No COVID-19-related deaths were recorded.

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