Navigating the coronavirus pandemic is difficult for everyone, but brings special challenges for transplant patients. UNOS Chief Medical Officer David Klassen, M.D., answers questions for patients about COVID-19 and the waiting list, inactivation, donor testing and other important topics.
Frequently asked questions
Are all transplant programs changing appointments/clinics/lab tests?
Each program is making decisions based on the availability of staff to help you and their assessment of the risk to you of continuing these services in the short term. In some cases, programs are temporarily postponing some services or making new arrangements (such as telemedicine appointments) in the interest of patient safety.
Your transplant team is the best source of information regarding their current schedule and arrangements. Keep in mind that they may continue to be adjusting them to meet new needs. If you have a scheduled appointment or procedure, you may wish to contact them in advance to see if anything has changed.
If I do not get labs or other testing as scheduled, will that affect my listing status?
The Organ Procurement and Transplantation Network has temporarily changed policy requirements for transplant programs. If the program can’t perform a test because of COVID-19, or if it believes doing a test right now would expose patients to unnecessary risk, the program may instead submit the most current results available for you. Doing so will not affect your current listing status.
This is a temporary measure. Once testing can be performed routinely nationwide, programs will be expected to resume their normal schedule.
What happens if I am temporarily put in an inactive status? Do I lose any priority on the waiting list?
Some transplant programs, using their medical judgment, are determining it is best not to currently accept organ offers for some transplant candidates. This is based on the relative risk of your potential exposure to the virus during and soon after surgery as compared to your current level of urgency for a transplant.
A temporary inactivation does not mean that you are removed from the waiting list. It means that for a period of time determined by the transplant program, you would not be considered for organ offers. The transplant program may reactivate you at any time they believe they can resume transplanting patients as usual.
If you are awaiting a kidney and/or pancreas transplant, or if you have a child younger than age 12 needing a lung transplant, the priority you accrue based on waiting time will continue as long as you remain inactive. When you are reactivated you will keep all the waiting time you have gained.
If you need a different organ type, or you are a lung candidate older than age 12, you only accrue waiting time while you are in an active listing category. In this case, your transplant program may temporarily change the settings of organ offers it will accept for you. That will allow you to remain active and continue to gain waiting time. You would, however, not be considered for organ offers until the program resets the criteria.
Your transplant program can discuss with you your current status and any conditions where they believe it is best to not accept organ offers for you for a limited time.
Are programs still doing living donor transplants?
Some transplant programs have temporarily postponed some or all living donor transplants. This is partly due to the availability of resources in the hospital for the surgery and immediate follow-up and partly to minimize the potential risk of exposure to the virus.
Some transplant programs continue to do living donor transplants as scheduled. Others have begun to resume them after initially postponing them. Your transplant team is best able to advise you on their current status and plans to resume operations.
Is there guidance on organ donor testing?
In response to inquiries regarding COVID-19, the American Society of Transplantation’s Infectious Disease Community of Practice has developed recommendations regarding organ donor testing. This guidance reflects the current state of knowledge and involves questions pertaining to screening and testing of living and deceased donors in the COVID era. Learn more here.
Are people who have had COVID-19 eligible to be organ donors?
At this time, leading transplant professional societies recommend that individuals known to be positive for COVID-19 should not be considered for organ donation. This recommendation will continue to be assessed, and could change in the future, as more becomes known about the disease and how it affects people who currently have it or have been exposed to it.
If my relative or friend needs a transplant, or just had a transplant, can I visit them at home or in the hospital?
In general, you should follow current medical recommendations for social distancing. The federal Centers for Disease Control and Prevention is continually updating its COVID-19 resource page with guidance and information. If you have specific questions about contact, your friend or loved one’s transplant team may offer more guidance.
Keep in mind that all transplant recipients take medicine to prevent organ rejection. That same medication may lower their normal immune response to common illnesses. People who have recently had an organ transplant often are on higher doses of these medications and must take additional precautions to lower their risk of infection.
Even if you are unable to visit them close and in person, you can continue to show your support and caring by sending them a card or gift, a call or video chat, or supporting them on social media.
ACTION, PHTS, Starzl Network, and IROC:
- COVID-19 FAQs: For children with Solid Organ Transplant or Heart Failure
- COVID-19: What Parents Should Know
The American Society of Transplantation: Transplant community FAQ resource
Pediatric Infectious Diseases Society: Solid Organ Transplantation (SOT) Summary Points for School Entry
Top OPTN Patient Services Hotline questions
Answering the questions you have been asking, UNOS Chief Medical Officer David Klassen, M.D., addresses COVID-19 concerns for organ donation and transplantation.
- What centers are not doing transplants and what does that mean for me?
- Why are living donor transplants being cancelled?
- Should transplant recipients be concerned during this time?
- I’m on the waitlist. Should family members visit?
- Could kidneys be infected if virus attacks the respiratory system?
- Are all patients at my center inactive? What does inactivation mean to me?
- If kidney transplant recipient has COVID-19, what can prevent acute kidney injury?
- Are organs of diseased COVID-19 patients being donated?
- I want to learn more about COVID-19’s impact on donation.
- Additional questions received during webinar
Coronavirus and Kidney Patients
A webinar, sponsored by the American Society of Transplantation and American Society of Transplant Surgeons, provides in-depth answers to COVID-19 patient questions for recipients and candidates. Watch the recording.
American Association of Kidney Patients webinar, “Coronavirus and Transplant Patients: Get the Facts, Save a Life.”
Learn important information regarding the impact of COVID-19 on kidney transplant recipients and individuals waiting for a kidney transplantation. Find out what questions, you as the patient, should be raising to your care team. Emily Blumberg, MD and Lloyd Ratner, MD, MPH, FACS will lead the webinar. Watch the recording.
Transplant Families webinar, “COVID-19 Q&A for pediatric patients”
Transplant Families, in partnership with several pediatric transplant centers and professional organizations, hosted a COVID-19 Question & Answer session to help address parental concerns as it pertains to the virus and pediatric transplant community. Watch the recording.
“The transplant community shares the common goal of saving as many lives through transplantation as possible.”
Brian Shepard, CEO, United Network for Organ Sharing
Risk of transmission
Risk of transmitting disease through solid organ transplantation is not known at the time. The Centers for Disease Control and Prevention COVID-19 website provides the most up to date information regarding recommended precautions, global risk assessment, and travel.