A woman in Michigan died 61 days after she received a pair of lungs from an organ donor who had been infected with the coronavirus, according to a case report published this month.
There was no indication that the donor, a woman fatally injured in a car accident, had Covid-19. A radiograph of her chest had seemed clear, and a nasal-swab test for the coronavirus had returned a negative result.
But the doctors who worked with the lung recipient at University Hospital in Ann Arbor, Mich., last fall began to question those results when their patient’s condition worsened. They concluded that the donor did indeed have Covid-19 — and that her lungs had infected not only the transplant patient, but also the surgeon.
It was the first confirmed case of a patient contracting the virus from the patient’s organ donor, according to the authors of the peer-reviewed report, which was published in The American Journal of Transplantation on Feb. 10.
“We want the transplant community to be aware that this can happen, and also that there may be things we can do to improve our success in screening patients for Covid,” said the surgeon, Dr. Jules Lin, an author of the report and the surgical director of the lung transplant program at Michigan Medicine, the health system of the University of Michigan.
The report said that medical professionals should consider testing lung donors for the coronavirus using a sample from their lower respiratory tract, which extends into the lungs — beyond the reach of a nasal swab. That kind of testing, which is invasive and not recommended for the general public, is not always available; currently, only about one-third of donated lungs are tested this way.
Dr. David Klassen, the chief medical officer at the United Network for Organ Sharing, the nonprofit organization that manages the nation’s organ transplant system, said the case in Michigan was “very significant” despite its rarity.
“We want to minimize any chances of this reoccurring,” he said.
Every organ donor in the United States is tested for the coronavirus in some way, Dr. Klassen said. The tests are not conducted by transplant surgeons; instead, they are typically overseen by nonprofit groups known as organ procurement organizations, which operate across the United States.
The Association of Organ Procurement Organizations referred questions to Gift of Life Michigan, which was not involved in this case. Its chief clinical officer, Bruce Nicely, said that many labs had refused to run samples from the lower lungs early in the pandemic, fearing that the procedure could contribute to the spread of the coronavirus.
“In response to the recommendations of the study, we are all for recommendations that improve safety and reduce the risk of infection,” Mr. Nicely said, adding that his organization has found a laboratory partner that is able to conduct testing of the lower respiratory tract.
When organs become available, time is of the essence. Some health facilities don’t have the resources to test donors’ lower respiratory tracts quickly for Covid-19. Given those constraints, there is no requirement that lung donors be tested this way.