Practical Considerations for Solid Organ Transplantation During the COVID-19 Global Outbreak: The Experience from Singapore

• Published in: Transplantation direct Vol. 6; no. 6; p. e554
• Main Authors: Chung, Shimin Jasmine, Tan, Ek Khoon, Kee, Terence, Krishnamoorthy, Thinesh Lee, Phua, Ghee Chee, Sewa, Duu Wen, Ong, Boon-Hean, Tan, Teing Ee, Sivathasan, Cumaraswamy, Gan, Huei Li Valerie, Goh, Brian Kim Poh, Jeyaraj, Prema Raj, Tan, Ban Hock
• Format: Journal Article
• Language: English
• Published: The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc 01.06.2020; Wolters Kluwer Health; Wolters Kluwer
• Subjects: Review
• ISSN: 2373-8731; 2373-8731
• DOI: 10.1097/TXD.0000000000001002

The current coronavirus disease 2019 (COVID-19) pandemic has not only caused global social disruptions but has also put tremendous strain on healthcare systems worldwide. With all attention and significant effort diverted to containing and managing the COVID-19 outbreak (and understandably so), essential medical services such as transplant services are likely to be affected. Closure of transplant programs in an outbreak caused by a highly transmissible novel pathogen may be inevitable owing to patient safety. Yet program closure is not without harm; patients on the transplant waitlist may die before the program reopens. By adopting a tiered approach based on outbreak disease alert levels, and having hospital guidelines based on the best available evidence, life-saving transplants can still be safely performed. We performed a lung transplant and a liver transplant successfully during the COVID-19 era. We present our guidelines and experience on managing the transplant service as well as the selection and management of donors and recipients. We also discuss clinical dilemmas in the management COVID-19 in the posttransplant recipient.