Korean J Transplant.  2022 Nov;36(Supple 1):S99. 10.4285/ATW2022.F-2198.

A case report on South Korea’s first organ donation in a patient with cerebral edema caused by COVID-19

• Chang SJ
• Kim MH
• Park YS
• Lee JRL
• Moon IS

• KMID: 2535615
• DOI: http://doi.org/10.4285/ATW2022.F-2198

Abstract

Background
From January to July 2022, a total of 24 patients diagnosed with COVID-19 were assessed for brain death donor in South Korea. Among them, 13 patients tested negative for COVID-19, two patients did not re-test, one patient tested false posi-tive, and a total of eight patients tested positive for COVID-19 during their first brain death examination. This study aims to report the first case of organ donation in South Korea completed by the patient whose underlying cause of brain death was cerebral edema caused by COVID-19.
Methods
A retrospective study was conducted by review the medical records from March 23 to 24, 2022.
Results
A healthy 6-year-old male patient visited the hospital on March 03, 2022, and presented with high fever (>40C) that lasted more than 12 hours, loss of consciousness, and convulsions. He was diagnosed with R/O COVID-19 MIS-C, myocarditis. Although remdesivir treatment was considered, it was not administered as it is authorized for ages 12 and above. On the fifth day, he was presumed brain death, and his parents gave consent for organ donation. Medical advice was provided by the Division of Infectious Diseases: it is recommended to end quarantine after 20 days and to confirm that cycle threshold value is above 25 when using operating rooms. Following their advice, the CT value was tested at 28.85 for the 20th day and the patient conducted the first brain death test. The next day, donated organs were heart, liver, and kidneys. Each recipient recovered well after 6 months, and none of the recipients were infected with COVID-19.
Conclusions
The study confirmed that critical COVID-19 patients can proceed with safe organ donations after sufficient quarantine periods and confirmation of CT values. Therefore, inclusion of COVID-19 positive patients as potential brain death donors may help reduce the shortage of organ donors.