Coronavirus disease-19 has had a marked impact on the transplant population and processes of care for transplant centers and organ allocation. Several single-center studies have reported successful utilization of deceased donors with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests. Our aims were to characterize testing, organ utilization, and transplant outcomes with donor SARS-CoV-2 status in the United States. We used Scientific Registry of Transplant Recipients data from March 12, 2020 to August 31, 2021 including a custom file with SARS-CoV-2 testing data. There were 35 347 donor specimen SARS-CoV-2 tests, 77.5% upper respiratory samples, 94.6% polymerase chain reaction tests, and 1.2% SARS-CoV-2–positive tests. Donor age, gender, history of hypertension, and diabetes were similar by SARS-CoV-2 status, while positive SARS-CoV-2 donors were more likely African-American, Hispanic, and donors after cardiac death (p-values <.01). Recipient demographic characteristics were similar by donor SARS CoV-2 status. Adjusted donor kidney discard (odds ratio = 2.08, 95% confidence interval [CI] 1.66–2.61) was higher for SARS-CoV-2–positive donors while donor liver (odds ratio = 0.44, 95% CI 0.33–0.60) and heart recovery (odds ratio = 0.44, 95% CI 0.31–0.63) were significantly reduced. Overall post-transplant graft survival for kidney, liver, and heart recipients was comparable by donor SARS-CoV-2 status. Cumulatively, there has been significantly lower utilization of SARS-CoV-2 donors with no evidence of reduced recipient graft survival with variations in practice over time.

中文翻译：

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美国已故供体 SARS-CoV-2 阳性器官在实体器官移植中的利用和结果

Coronavirus disease-19 对移植人群和移植中心的护理过程以及器官分配产生了显着影响。几项单中心研究报告成功利用了严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 检测呈阳性的已故捐赠者。我们的目标是在美国用供体 SARS-CoV-2 状态来描述测试、器官利用和移植结果的特征。我们使用了 2020 年 3 月 12 日至 2021 年 8 月 31 日的移植接受者科学登记数据，包括带有 SARS-CoV-2 测试数据的自定义文件。有 35 347 个供体标本 SARS-CoV-2 检测，77.5% 的上呼吸道样本，94.6% 的聚合酶链反应检测和 1.2% 的 SARS-CoV-2 检测呈阳性。供体年龄、性别、高血压和糖尿病病史在 SARS-CoV-2 状态方面相似，p值 <.01)。受体的人口统计特征与供体 SARS CoV-2 状态相似。SARS-CoV-2 阳性供体的调整后供肾丢弃率（优势比 = 2.08，95% 置信区间 [CI] 1.66-2.61）高于供体肝脏（优势比 = 0.44，95% CI 0.33-0.60）和心脏回收率（比值比 = 0.44，95% CI 0.31–0.63）显着降低。肾脏、肝脏和心脏接受者移植后的总体移植存活率与供体 SARS-CoV-2 状态相当。累积起来，SARS-CoV-2 供体的利用率显着降低，没有证据表明受体移植物存活率随着时间的推移而有所变化。