Thursday, December 2

Some US Patients Awaiting Organ Transplantation Must Receive Covid Vaccine Or Be Removed From List | Vaccines and immunizations


Health systems in Colorado and Washington are removing unvaccinated patients from organ transplant lists, given research that unprotected recipients are much more likely to die from Covid-19.

UCHealth in Colorado told a patient on the kidney transplant waiting list that she needed to be vaccinated in the next 30 days or they would remove her from the list. Leilani Lutali said 9News that she was the patient in question and has not yet been vaccinated due to her religious views.

State Representative Tim Geitner, Republican, tweeted the letter he received on Tuesday saying the health system “denies life-saving treatment.”

It’s standard practice to require vaccinations before transplants, experts say, because anti-rejection drugs make recipients immunosuppressed and put them at extremely high risk of dying from infections, including the coronavirus.

UW Medicine also added the Covid vaccine as a condition for the transplant list. A few weeks ago, joining other vaccines needed for years. If patients choose not to get vaccinated, remote from the waiting list. In a informal Twitter poll From a transplant director, a third of those surveyed said their transplant centers had similar policies.

“Transplant patients are much more vulnerable to infection,” Dr. Camille Kotton, clinical director of transplantation and infectious diseases of the immunosuppressed host at Massachusetts General Hospital, told The Guardian in an email. are among those most at risk of developing a serious life – threatening Covid-19 “.

Transplant recipients who become ill with the coronavirus have a mortality rate of 20-30%, a surprisingly higher figure than the rest of the population, about 1.6%.

TO study July found that organ transplant recipients who were vaccinated before receiving a solid organ transplant were nearly 80% less likely to become infected with Covid, compared to those who were not fully vaccinated.

Vaccinating patients before the procedure makes it safer for them and those around them in the hospital during and after the transplant, Kotton said. And vaccines work much better before transplantation, because patients can generate a strong immune response before starting immunosuppressive drugs.

Vaccinated patients can also be considered for Covid-positive donor organs, a new step in the field of transplantation.

Even fully vaccinated recipients are at high risk of developing Covid-19. Transplant patients are 82 times more likely to develop breakthrough infections, and those infections are 485 times more likely to result in hospitalization or death, compared to other vaccinated people, said Dr. Dorry Segev, transplant surgeon and professor of epidemiology at Johns Hopkins. Guardian.

“If you are a transplant patient, you are very likely to become seriously ill and have a 10% chance of dying from such an infection,” he said.

Vaccination is just one way to ensure transplant patients make a successful recovery, he said.

“There is a precedent for all kinds of requirements that transplant patients must meet before they are considered eligible, before they can be included on the list,” Segev said. That includes vaccinations against diseases like measles, mumps and rubella, pneumococcus, meningococcus, and influenza, as well as checking cardiovascular health, quitting smoking or drinking, and more.

Doctors also assess whether a patient is “too risky to be transplanted,” Segev said. “If we think that they have too high a chance of dying if they are transplanted, then they are not a good candidate for this resource, which is a scarce resource and should be shared with all patients across the country.”

There are more than 100,000 people in Organ donation Waiting lists in the US, but only 39,000 transplants are performed each year.

“Clinicians must consider the short-term and long-term health risks to patients when considering whether to recommend an organ transplant,” said Dan Weaver, a spokesman for UCHealth.

Providers who require vaccination are not making a value judgment, Segev said. “They are seeing that we are still in a very aggressive fourth wave of Covid in this country. And nobody wants to transplant someone and then have them die a month later because they contracted Covid and are highly immunosuppressed. “




www.theguardian.com

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