When Heidi Ferrer took her own life after battling long-COVID complications for more than a year, her husband, Nick Guthe, wanted to donate her body to science. Since Ferrer had signed up to be an organ donor, however, the hospital honored her instructions and recovered several organs before disconnecting her from her ventilator. 

The Safety Debate

Mr. Guthe was concerned that his wife’s organs would not be healthy enough to safely transplant into other patients. “I thought that they would kill the people they gave these organs to,” he told one interviewer.

Guthe is not the only one who is concerned. Medical professionals are divided over whether or not it is safe to donate the organs of COVID illness survivors, people who died with asymptomatic COVID, and those who may have been suffering from long-COVID symptoms. 

What Precautions Are Taken?

During the initial spread of COVID-19 in the U.S., experts took a conservative approach toward organ recovery, but that is changing. “At the beginning of the pandemic, if you were positive, you just weren’t going to be a donor,” said Dr. Glen Franklin, medical adviser to the Association of Organ Procurement Organizations. “We didn’t know enough about the disease.” 

Now, potential donors are routinely screened for coronavirus infections before their organs are harvested. If the results are negative, the organs are typically considered safe for transplantation even if the donor has recovered from COVID, though there are no universally accepted guidelines concerning when organs can be safely transplanted from virus-positive bodies.

What are the Dangers?

The risk, says Dr. Zijian Chen, medical director of the Center for Post-Covid Care at the Mount Sinai Health System, is that surgeons may “give the patient COVID, along with the organ. It’s a tough ethical question. If the patient assumes the risk, should we do it?”

Some researchers fear that, despite the fact that most people with long COVID do not test positive for the infection, the virus may still be hiding in reservoirs within the body, including commonly transplantable organs.

Just last year, a woman was infected with the coronavirus after receiving the lungs of a donor who had tested negative after a nasal swab. Several similar cases were reported, so now tests are also conducted on tissue samples from the lower respiratory tracts of potential lung donors. Only if all tests are negative does the transplant proceed. 

Other organs can be affected by the disease, as well. After performing autopsies on 27 COVID victims, scientists in Germany found the virus in the kidney and heart tissues of over 60% of the deceased. Infection was also detected in liver, lung, and brain tissue. 

Do the Potential Benefits Outweigh the Dangers?

There is always the danger of disease transmission when organs are transplanted, but there is also an overwhelming need for lifesaving organs in the U.S. and an insufficient supply. More than 100,000 patients languish on waiting lists, and 17 of them die daily. As a result, rules for accepting organs from deceased donors who may have HIV or hepatitis C have been relaxed.

“It is really a risk-benefit calculation,” says Dr. David Klassen, chief medical officer at the United Network for Organ Sharing, which administers the nation’s organ procurement network. “Many people waiting for organs are deathly ill. Their lifespan may be down to a few days. If they don’t get a transplant, they will not survive.”

Another group, the American Society of Transplantation, said it would not procure any organs from any patient who had shown signs of illness or tested positive for the virus. If a deceased donor tests negative, however, said Dr. Deepali Kumar, president-elect of the society, even if they may have had long COVID, they would accept the organs. “If we start turning down everyone who has had COVID in the past,” he stated, “we’d be turning down a lot of organs.”

Proceeding with Caution

A recently updated report by a committee of the Organ Procurement and Transplantation Network highlighted the lack of information about long-term outcomes for recipients of organs from COVID survivors. It’s simply too soon to know the long-term effects. 

The authors recommend caution concerning transplantation of organs from donors who test positive for the coronavirus, particularly in light of the delta variant, which accounts for nearly all infections in the U.S. No statements or suggestions are made regarding long COVID. 

According to Dr. Chen, of the Mount Sinai Health System, organs from long-COVID patients usually perform normally on function tests, but he insists that recipients should be informed of the risks, nonetheless. Transplant patients are required to take immunosuppressant medications to prevent rejection of the organs. “If they get COVID, they’ll be susceptible to infections and poor healing,” Chen said. “I think, ethically, you need to let the patient know the risk is very real.”

What’s Considered Acceptable?

With so many factors at play, says Klassen, decisions must be made on a case-to-case basis. Before she died, Heidi Ferrer experienced pain in all her limbs, foot soreness that rendered her unable to walk, tremors that violently shook her body, insomnia, a racing heart, fluctuating blood sugar levels, brain fog, and despair. Her liver was “severely compromised” due to the large doses of ivermectin she had treated herself with. The hospital considered her a suitable donor.

Ferrer’s kidneys were transplanted into two California men with end-stage renal disease. No matches were found for her other organs. 

*Rabin, R. C. (2021, Nov. 7). She Died With Long Covid. Should Her Organs Have Been Donated? The New York Times. https://www.nytimes.com/2021/11/07/health/covid-organ-transplants.html?referringSource=articleShare

Much about the novel coronavirus, i.e., COVID-19, is still not fully understood. As research progresses and our knowledge of the virus increases, information can change rapidly. We strive to update all of our articles as quickly as possible, but there may occasionally be some lag between scientific developments and our revisions.