Can I still be an organ donor if I've had COVID-19?

Questions over organ donations from long-haulers Questions are growing over whether it is safe to accept organ donations from COVID-19 long-haulers.

TORONTO — Can someone who died of COVID-19 or had long-COVID donate their organs for transplantation? Can you transmit the virus through an organ donation? How has the pandemic changed the organ donation process? These are just a few of the questions people have around organ donations during the pandemic.

“Dawson’s Creek” screenwriter Heidi Ferrer endured the debilitating effects of long-COVID for more than a year before dying by suicide in May, according to multiple media reports at the time of her death. It’s what happened to her organs after, however, that also had her husband concerned, according to a New York Times article this week.

Nick Guthe wanted his wife’s body donated to science. But as someone who signed their donor card, Ferrer’s organs were used to save the lives of others.

She had developed severe inexplicable pain in her feet, heart palpitations, and digestive issues following her COVID-19 infection. Just weeks before her death, she also developed neurological issues including tremors and “brain fog.”

It all became too much for Ferrer, but as someone who spent much of her final year in agony, Guthe worried that his wife’s organ would not be safe for recipients.

So what do experts say and what are the rules around organ donation?

Regulations are made by provincial organ donation organizations (OPOs), said Dr. Deepali Kumar, director of transplant infectious diseases at the University Health Network’s Ajmera Transplant Centre in Toronto, one of the largest transplant centres in the country.

In Ontario, for example, patients who have had COVID-19 in the past are accepted.

“In order to ensure that there is no virus that can be transmitted, we usually like to wait for a certain period of time before we accept those people as donors … it’s a minimum of 21 days, but longer is better,” Kumar, who also serves on the American Society of Transplantation’s board of directors and is their president-elect, told CTV News Toronto.

“By about that time, people have negative swabs.”

There is some evidence that pieces of the SARS-CoV-2 virus can be found in different organs, but there is no indication they are able to multiply, she explained. She pointed to the U.S., where kidneys, livers, and sometimes hearts from donors who are “COVID-positive” are accepted, and no transmissions of the virus have resulted from those donations.

“Even if your COVID swab is positive, and you're about a month from your infection, you're probably OK to donate abdominal organs, but not your lungs.”

Technically, anyone can be a potential donor, regardless of medical conditions, according to the Canadian Blood Services (CBS) website.

“Even individuals with serious illnesses may sometimes be donors. All potential donors are evaluated on an individual, medical, case-by-case basis,” the program says.

Ontario’s Organ and Tissue Donor Registration form, for example, does not ask registrants to disclose their health status, even though there are different types of active infections that can prevent an individual from being a donor, such as those who have HIV. Donors with infections that have been resolved or are in a dormant state, like hepatitis B, can donate.

For those concerned about long-COVID and organ donation, Kumar explained that experts believe it is an immune phenomenon that is wreaking havoc on the body, not the actual virus.

“The virus itself is likely to be long gone, but it kind of leaves that long lasting signature of revving up your immune system. So people get all sorts of symptoms,” Kumar explained.

EVERY DONATION COUNTS

The donation process is not static, however, and Kumar noted that screening procedures are constantly being evaluated.

“When COVID first emerged, the first thing we did was we evaluated our screening for COVID and made sure that we were safely doing transplants. So definitely … keeping up with whatever is new and making sure that our criteria are up to date.”

With more than 4,400 Canadians on the waiting list for a lifesaving transplant, every potential donation matters, especially when the number of actual organ donations are far below what is needed, according to the CBS. Hundreds of Canadians die each year waiting for a match to come through, with only 32 per cent of Canadians having registered their intention to donate, even though 90 per cent support the practice.

“Organ transplantation and organ donation is a risk-benefit,” Kumar said.

During the pandemic, extensive tests are conducted on donors to make sure they are free of infection before accepting the organs.

“The main thing is for the general public to know that our organ supplies is very safe and as data emerges, we are constantly evaluating the safety of the organ supply and making sure that we have all the screening in place for donors...nothing is 100 per cent, but we try to come as close as possible to that.”