• Daniel R Kaul, Andrew L Valesano, Joshua G Petrie, Rommel Sagana, Dennis Lyu, Jules Lin, Emily Stoneman, Lane M Smith, Paul Lephart, and Adam S Lauring.
• Division of Infectious Disease, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan.
• Am. J. Transplant. 2021 Aug 1; 21 (8): 2885-2889.

AbstractWe describe a case of proven transmission of SARS-CoV-2 from lung donor to recipient. The donor had no clinical history or findings suggestive of infection with SARS-CoV-2 and tested negative by reverse transcriptase polymerase chain reaction (RT-PCR) on a nasopharyngeal (NP) swab obtained within 48 h of procurement. Lower respiratory tract testing was not performed. The recipient developed fever, hypotension, and pulmonary infiltrates on posttransplant day (PTD) 3, and RT-PCR testing for SARS-CoV-2 on an NP swab specimen was non-reactive, but positive on bronchoalveolar lavage (BAL) fluid. One thoracic surgeon present during the transplantation procedure developed COVID-19. Sequence analysis of isolates from donor BAL fluid (obtained at procurement), the recipient, and the infected thoracic surgeon proved donor origin of recipient and health-care worker (HCW) infection. No other organs were procured from this donor. Transplant centers and organ procurement organizations should perform SARS-CoV-2 testing of lower respiratory tract specimens from potential lung donors, and consider enhanced personal protective equipment for HCWs involved in lung procurement and transplantation.© 2021 The American Society of Transplantation and the American Society of Transplant Surgeons.

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