Should woman’s organs have been donated?
COVID-19 ravaged Heidi Ferrer’s body and soul for more than a year, and in May the “Dawson’s Creek” screenwriter killed herself in Los Angeles. She had lost all hope.
“I’m so sorry,” she said in a goodbye video to her husband and son. “I would never do this if I was well. Please understand. Please forgive me.”
Her husband, Nick Guthe, a writer and director, wanted to donate her body to science. But the hospital said it was not his decision to make because Ferrer, 50, had signed up to be an organ donor. So specialists recovered several organs from the body before disconnecting her from a ventilator.
Guthe worried that following his wife’s lengthy illness, her organs may not have been safe to donate to other patients. “I thought that they would kill the people they gave these organs to,” he said.
The case highlights an urgent debate among medical professionals about whether the organs of people who survived COVID-19, and even of those who died with the illness, are really safe and healthy enough to be transplanted.
Potential donors are routinely screened now for coronavirus infections before their organs are removed. Generally, the organs are considered safe for transplantation if the test is negative, even if the donor has recovered from COVID-19. But there is no universally accepted set of recommendations regarding when organs can be safely recovered from virus-positive bodies and transplanted to patients in need.
Complicating the question is the fact that people with long COVID, whose debilitating symptoms may persist for months, mostly do not test positive for the infection. Some researchers fear the virus may be present nonetheless, hiding in so-called reservoirs within the body — including some of the very organs given to transplant patients.
The risk is that surgeons may “give the patient COVID, along with the organ,” said Dr. Zijian Chen, medical director of the Center for POST-COVID Care at the Mount Sinai Health System. “It’s a tough ethical question. If the patient assumes the risk, should we do it?”
Disease transmission is always a concern when organs are transplanted, but there is tremendous demand for lifesaving organs in the United States and a limited supply. More than 100,000 people are on waiting lists, and 17 people die each day while they wait.
In recent years, rules for accepting organs from deceased donors who may have infections like HIV or hepatitis C have been relaxed.
Organ recovery practices vary widely from one center and region to the next, influenced by local availability of donor organs.
“At the beginning of the pandemic, if you were positive, you just weren’t going to be a donor. We didn’t know enough about the disease,” said Dr. Glen Franklin, medical adviser to the Association of Organ Procurement Organizations.
Generally, surgeons have avoided transplanting the lungs of patients who died of COVID-19, because it is a respiratory illness that can cause long-term lung damage.
A woman was infected with the coronavirus last year after receiving the lungs of a donor who had tested negative for the virus after a nasal swab, according to a case report published in the American Journal of Transplantation.
Now additional tests are conducted on samples of tissues taken from the lower respiratory tracts of potential lung donors; the transplant proceeds only if all the tests are negative for the infection.
Meanwhile, scientists in Germany performed autopsies on the bodies of 27 patients who died of COVID19 and found the virus in the kidney and heart tissues of more than 60% of the decedents. The researchers also found the infection in lung, liver and brain tissue.