Using SARS-CoV-2-Positive Donors Under 1 Year of Age: A Case Series of Successful Combined Liver-Pancreas and Isolated Liver Pediatric Transplantation

作者：Brownell M, Gupta P, Moris D, Ekong U, Khan K, Pavone A, Gondolesi I, Gopwani S, Fitzpatrick M, Matsumoto C, Rumbo C, Yazigi N, Fishbein T, Gondolesi G · 发表于：Pediatric transplantation · 年份：2025 · DOI：10.1111/petr.70196 · 研究领域：COVID‐19、SARS‐CoV‐2、pediatric liver transplant、pediatric pancreatic‐liver transplant

BACKGROUND: The rates of organ transplantation declined during the COVID-19 pandemic as donors testing positive for SARS-CoV-2 on respiratory PCR were ineligible to donate. The implications of this practice are important for patients with limited donor pools, such as pediatric populations. Several case studies have demonstrated non-inferior outcomes in adult patients receiving non-pulmonary organ transplants from COVID-positive adult donors. The feasibility and safety of such a transplant have yet to be established for donors under 1 year of age. CASE PRESENTATION: We present two cases of non-pulmonary, solid organ transplantation from donors under 1 year of age testing positive for COVID-19 on respiratory PCR in the absence of respiratory or systemic symptoms. The first patient was a 15-month-old with Wolcott-Rallison Syndrome presenting with congenital diabetes and recurrent hepatitis. The patient underwent a combined liver-pancreas transplant from an 8-month-old donor. Postoperatively, the recipient did not have any complications related to COVID-19 but experienced a self-limited, transient respiratory distress. The second patient was a 5-month-old with methylmalonic acidemia experiencing recurrent metabolic crisis. The patient received a liver transplant from a 3-month-old donor. Immediate postoperative imaging revealed anastomotic thrombosis of the hepatic artery managed with arterial reconstruction. CONCLUSION: Our case series is the first to establish the feasibility...