She Died With Long COVID. Should Her Organs Have Been Donated?

COVID-19 ravaged Heidi Ferrer's soul and body for over a year. In May, the screenwriter of "Dawson's Creek," committed suicide in Los Angeles. She was hopeless.
In a goodbye video she told her husband and son, "I'm so sorry." "I wouldn't do this if it weren't for my health. Please be understanding. I am sorry.

Nick Guthe, her husband and a director of writing, was interested in donating Ferrer's body to science. The hospital denied that Guthe made the decision because Ferrer (50) had signed up as an organ donor. Before removing Ferrer from a ventilator, specialists removed several organs from her body.

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Guthe was concerned that his wife's organs might not be safe to donate after her long illness. He said, "I believed that they would kill those they gave these organs too."

This case highlights the urgent need for medical professionals to debate whether organs from people who have survived COVID and those who died from the disease are safe and healthy enough for transplantation.

Before organs are taken out, potential donors are routinely tested for coronavirus infection. The organs can be transplanted if they are negative for COVID. There is not a universally accepted list of guidelines regarding when organs are safe to be recovered from viruses-positive bodies and transplanted into patients who need them.

The fact that long-term COVID patients, who may have debilitating symptoms for several months, are most likely not to be infected, complicates the matter. Researchers fear that the virus could still be hiding in the body's so-called reservoirs, including transplant patients.

There is a risk that surgeons could "give the patient COVID, together with the organ," Dr. Zijian Chen of Mount Sinai Health System's Center for Post-COVID Care said. It's an ethically difficult question. Should we accept the risk if the patient is willing to take it?

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Although disease transmission is always a concern in organ transplants, there is a lot of demand and limited supply. There are more than 100,000 people on waiting lists and 17 people who die every day while they wait.

Recent years have seen a relaxation in the rules regarding organ donation from deceased donors with HIV/hepatitis C.

The availability of organ donors in each region can influence the recovery procedures. This is why they vary from one area to another. Procurement centers are under pressure to keep their numbers high, so transplant centers must complete a certain amount of procedures every year in order to maintain their certification.

The approach to organ recovery when COVID first started to spread in the United States was conservative. This is now changing.

"At the start of the pandemic you couldn't donate if you were positive. "We didn't have enough information about the disease," Dr. Glen Franklin, medical advisor to the Association of Organ Procurement Organizations, said.

However, major organ transplant agencies in the country have adopted a variety of approaches.

Because COVID is a serious respiratory disease that can lead to lung damage, surgeons tend not to perform transplants on patients who have died.

According to an American Journal of Transplantation case report, a woman contracted the coronavirus from receiving the lungs of a donor. The virus was tested negative after a nasal swab.

A few cases similar to these were reported. Additional tests are now being done on tissues from potential lung donors' lower respiratory tracts. The transplant will only proceed if all tests are negative.

Other organs could also be affected. German scientists performed autopsies of 27 COVID victims and discovered the virus in their kidneys and heart tissue. Researchers also discovered the infection in brain, liver, and lung tissue.

Franklin of the organ procurement organization said that even if donors are positive for the virus they can still be resuscitate abdominal organs below their diaphragm.

Dr. David Klassen is the chief medical officer of the United Network for Organ Sharing. He said that decisions should be made "case-by case".

He said, "It's really a risk-benefit analysis." Many people who are waiting for organs may die. They will die if they don't receive a transplant.

Another group of physicians, the American Society of Transplantation said that they wouldn't accept any organs from patients who showed signs of illness or had positive tests for infection.

Dr. Deepali Kumar is the president-elect.

Kumar stated that even though a deceased donor might have been diagnosed with COVID for a long time and had a negative test, they would still be allowed to take the organs.

A committee from the Organ Procurement and Transplantation Network recently published a report that summarized evidence regarding organ recovery from donors who have a history COVID. The lack of information on the long-term outcomes of recipients was highlighted by the authors.

This document examines organ recovery from deceased donors that have tested positive for coronavirus. It also includes organ recovery from deceased donors who survived COVID-19 but did not test negative.

The report stated that all of these cases have long-term consequences for recipients and donors.

The authors advised that organ transplantation from donors with coronavirus should be done cautiously.

It was also mentioned that the "delta variant" of the virus -- now responsible for nearly all US infections -- is more infective than the previous versions. Therefore, the length of infectivity has not been fully assessed.

Long COVID is not mentioned in the report. Specialists in the treatment of patients with COVID say that although they may report persistent symptoms, most of them have normal functioning organs.

"For people who did not have end-organ damage due to COVID, there are ways of detecting it," Dr. Jennifer D. Possick (associate professor at Yale School of Medicine) said. Possick runs a long COVID recovery program at Yale New Haven Hospital.

She cautioned that organ function tests aren’t perfect. She said, "We are only as good and reliable as the existing tests." "This is uncharted territory."

Chen of Mount Sinai Health System agreed that organs taken from COVID long-term patients perform well on functional tests, but cautioned that recipients need to be aware of the potential risks.

One concern is that transplanted organ recipients are often required to take medication that suppresses the immune system in order to prevent rejection.

Chen stated that COVID can make patients more susceptible to infection and lead to poor healing. "Ethically, it is important to inform the patient about the risks."

Ferrer kept a detailed record of her experience before she died. She wrote "COVID feet" which made her feet so painful that she couldn't walk. Her body began to shake violently from a tremor. All limbs feel pain. Insomnia and despair that are unstoppable

Her heart raced. Her blood sugar levels fluctuated. Worst, she couldn’t think straight.

The hospital believed she would be a good donor.

Guthe, her husband, said that she tried to explain the difference between COVID and 'long haul'. "People get COVID and get better. It affected all systems of her body."

He said that two Californian men suffering from end-stage renal disease were the recipients of her kidneys. Her other organs were not compatible. Guthe warned the hospital that her liver was in serious condition. She had been taking large amounts of ivermectin (an anti-parasitic drug, falsely claimed to cure COVID) and a diet that included almost two-thirds of an ounce of olive oil per day.

Guthe, his son, and other family members, found the five-day wait before Ferrer was disconnected from the ventilator at the hospital to be excruciating. Guthe stated that he had promised her he would inform others about the long-term COVID.

He now has another mission.

He said, "Heidi is a very generous person, but she wouldn't have wanted this." "We must create guidelines to determine what is safe and unsafe."

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