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Background <p>Lung transplant is a life-saving therapy for end stage lung disease. However, the shortage of donor organs limits its availability. The safety of utilizing lungs from COVID-19-positive donors remains uncertain due to potential transmission risks and variable practice patterns. This study aimed to compare allografts from COVID-19-positive donors and COVID-19-negative donors during lung transplantation, with a focus on survival, length of hospital stay, dialysis, 30-day graft failure, 30-day mortality and postoperative ECMO support.</p> Methods <p>PubMed, Scopus, and Embase were assessed. Four studies including 5,921 patients were included. Overall survival was estimated by the Kaplan-Meier method and compared with Cox proportional hazards models. Random-effects models were applied for all pooled analyses.</p> Results <p>There was no difference in overall survival (HR 1.35; 95% CI 0.67–2.71; <i>p</i> = 0.40), and dialysis (RR = 1.38; 95% CI 0.52–3.64; <i>p</i> = 0.52) between groups. Recipients of allografts from COVID-19-positive donors had longer hospital stay (MD = 6.43 days; 95% CI 1.53–11.33; <i>p</i> = 0.01). There were no significant differences between groups for 30-day graft failure (RR = 1.08; 95% CI 0.83–1.39; <i>p</i> = 0.58), 30-day mortality (RR = 1.76; 95% CI 0.75–4.13; <i>p</i> = 0.19), or ECMO within 72&#xa0;h (RR = 0.61; 95% CI 0.14–2.58; <i>p</i> = 0.50).</p> Conclusions <p>Although outcomes of transplantation were comparable, recipients of lungs from COVID-19-negative donors had shorter hospital stay. However, these results should be interpreted with caution due to the limited number of available comparative studies reflecting the current evidence base, and variations in methods of ascertaining COVID-19 positivity across studies.</p>

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Outcomes of lung transplantation from COVID-19-positive donors: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月8日

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  • Udochukwu Godswill Anosike,
  • Wellgner Fernandes Oliveira Amador,
  • Leonardo Braga Goncalves,
  • Sonia Ijeoma Etumudon,
  • Emmanuel Korir,
  • Theodora Cruz de Assis,
  • Roy Olunga,
  • Vincent Kipkorir,
  • Arkadeep Dhali,
  • Wongi Woo,
  • Elliot Wakeam

摘要

Background

Lung transplant is a life-saving therapy for end stage lung disease. However, the shortage of donor organs limits its availability. The safety of utilizing lungs from COVID-19-positive donors remains uncertain due to potential transmission risks and variable practice patterns. This study aimed to compare allografts from COVID-19-positive donors and COVID-19-negative donors during lung transplantation, with a focus on survival, length of hospital stay, dialysis, 30-day graft failure, 30-day mortality and postoperative ECMO support.

Methods

PubMed, Scopus, and Embase were assessed. Four studies including 5,921 patients were included. Overall survival was estimated by the Kaplan-Meier method and compared with Cox proportional hazards models. Random-effects models were applied for all pooled analyses.

Results

There was no difference in overall survival (HR 1.35; 95% CI 0.67–2.71; p = 0.40), and dialysis (RR = 1.38; 95% CI 0.52–3.64; p = 0.52) between groups. Recipients of allografts from COVID-19-positive donors had longer hospital stay (MD = 6.43 days; 95% CI 1.53–11.33; p = 0.01). There were no significant differences between groups for 30-day graft failure (RR = 1.08; 95% CI 0.83–1.39; p = 0.58), 30-day mortality (RR = 1.76; 95% CI 0.75–4.13; p = 0.19), or ECMO within 72 h (RR = 0.61; 95% CI 0.14–2.58; p = 0.50).

Conclusions

Although outcomes of transplantation were comparable, recipients of lungs from COVID-19-negative donors had shorter hospital stay. However, these results should be interpreted with caution due to the limited number of available comparative studies reflecting the current evidence base, and variations in methods of ascertaining COVID-19 positivity across studies.