COVID-positive organ donors

From page 1 infection or other adverse effects in the recipients. “At the beginning we were kind of nervous, but now we just follow the protocol,” Goss says.

“We really don’t even think about it much anymore because we’ve done so many of them and we know there hasn’t been any spread.”

Evidence-based practice

Transplant centers across the nation have seen similar success in the use of organs from COVID-positive patients, both living and deceased, according to evidence compiled by the Ad Hoc Disease Transmission Advisory Committee of the Organ Procurement & Transplantation Network. The network is the public-private partnership that links professionals involved in the U.S. donation and transplantation system.

The committee’s most recent report covers evidence from various scenarios involving COVID-positive donors. Among the findings it points to is that deceased donors who did not have active COVID symptoms when they tested positive 21-90 days after the onset of the virus “are unlikely to transmit infection.”

Those efforts have brought results, Goss says.

Based on figures compiled by the Scientific Registry of Transplant Recipients, he says, the medical center outpaces many of the nation’s other 250 or so transplant centers in various categories for racial and ethnic minority recipients. For example, more than half of the heart transplants at Baylor St. Luke’s transplant center are for patients who are Black, more than double the national rate of 21.6%. Liver transplants for Black and Latino patients at the medical center exceed the national rate by nearly 20%.

Goss says demographics are part of the reason for the higher percentage of transplant recipients from minorities at Baylor St. Luke’s. Houston is among the most diverse cities in the nation, with large populations of Latino, Black and Asian residents.

That said, Baylor St. Luke’s, Goss says, has been intentional about getting minorities onto national waiting lists for organ donations. The staff assists prospective recipients throughout the evaluations and appointments that are prerequisites to qualifying a patient to get in line for an organ donation, even checking that they have transportation to appointments.

The transplant team — including doctors, nurses, care coordinators, financial counselors and social workers — has people with the language skills and cultural expertise to connect with people of various ethnicities and backgrounds.

To ensure that patients who aren’t fluent in English comprehend and correctly complete the necessary forms, staff provide additional direct support.

Goss points out that many prospective transplant patients are daunted just by the enormity of the Texas Medical Center campus, where Baylor St. Luke’s is located. On a

Organ Donation In

104,562

• More than 400,000 people are alive today with a functioning transplant.

• In 2022, there were 42,887 transplants, a record number and almost 4% more than the year before.

• In September 2022, the total number of transplants ever done in the U.S. hit 1 million.

• Half of all the transplants ever performed in the U.S. have taken place in just the past 15 years.

typical day, 250,000 people are on the campus, which is in the middle of a bustling city.

Non-English speakers and those unfamiliar with the campus may find it frightening and overwhelming to navigate, Goss says. “The schedulers and the coordinators and nurses and everybody have to spend a lot of time trying to get these people in the right spot,” he says.

“We try to individualize how we take care of (transplant candidates), so it’s not just a cookie cutter thing where people will fall off the list or kind of fall off the radar,” he says.

After his transplant surgery, Figueroa made a video about his experience for Baylor St. Luke’s YouTube page. In it, he encourages others who might need a transplant to seek out care. “There’s nothing scary about the process,” he says in the short video. “The outcome will always be better than what you’re going through.”

The report goes on to say that the decision on whether to use organs in such cases should factor in several variables, including the recipient’s risk of death or further complications without immediate transplant. Individual transplant centers make the final decision on which organs to accept for transplant.

Maximizing the supply

Dr. Raquel García-Roca, program director of abdominal transplant and surgical director of renal transplant at Loyola University Medical Center in suburban Chicago, says that hospital began using organs from deceased COVID-positive donors in spring 2022. The medical center is within the Loyola Medicine system, which is part of Trinity Health.

García-Roca and the other transplant doctors at the medical center, in consultation with its infectious disease experts, decided that since there were no documented cases of COVID infection transmission through organ transplants, opportunities to help gravely ill patients were being missed by rejecting these organs. “Because the number of asymptomatic (COVID) infections are so high, we ended up losing a large amount of good organs,” she notes.

Through mid-December, GarcíaRoca estimates about 20 liver, kidney and

Presidents And Ceos

Kevin J. Slavin is retiring at the end of this year as president and chief executive of St. Joseph’s Health of Paterson, New Jersey.

The St. Joseph’s Health Board of Trustees has convened a search committee to oversee a national search for his successor.

Ascension has made these changes: Tim Adams to regional operating officer and senior vice president for Ascension, overseeing facilities in 10 states. He was president and chief executive of the Ascension Saint Thomas subsystem in Nashville, Tennessee. Fahad Tahir will succeed Adams as Saint Thomas president and chief executive. Tahir was chief strategy officer of Ascension and president and chief executive of Ascension Saint Thomas Hospital Midtown and West campuses in greater Nashville.

Bon Secours Mercy Health has made these changes: Brian Gwyn to president of Mercy Health’s Cincinnati market, effective Feb. 6. He was Atrium Health senior vice president and west market president. Gwyn succeeds Dave Fikse, who retired last year.

Andrew Morgan to president of Mercy Health — Tiffin Hospital and Mercy Health — Willard Hospital in Ohio. He had been interim president since July. Sonya Selhorst to president of Mercy Health — Defiance Hospital in Defiance, Ohio. She had been interim president since July.

Stephanie Manson to Our Lady of Lourdes Health market president, from chief operating officer of Our Lady of the Lake Health. Our Lady of Lourdes is based in Lafayette, Louisiana, and Our Lady of the Lake Health is based in Baton Rouge, Louisiana. Both are part of Franciscan Missionaries of Our Lady Health System.

Jeffrey Methven to president and chief executive of St. Mary’s Healthcare in Amsterdam, New York. He was executive vice president of Saratoga Hospital/Albany Med Health System in New York. Methven succeeds Scott Bruce, who is retiring.

Dr. Timothy Quinn to president and chief executive of Mercy Cedar Rapids, Iowa. He was executive vice president and chief of clinical operations. He replaces Timothy Charles, who retired Dec. 31.

Kelly Morgan plans to retire this summer as president and chief executive of CHI Mercy Health in Roseburg, Oregon. CHI Mercy parent company CommonSpirit Health is conducting a national search for his successor.

Administrative Changes

Kathy Donovan to chief operating officer of Hospital Sisters Health System of Springfield, Illinois.

Ken James to market chief operating officer of Mercy Health — Cincinnati, part of Bon Secours Mercy Health.

Matthew Brandt to chief financial officer of Saint Francis Healthcare System in Cape Girardeau, Missouri.

Tamera Larsen-Engelkes to chief nursing officer at Avera McKennan Hospital & University Health Center in Sioux Falls, South Dakota.

St. Mary’s Healthcare in Amsterdam, New York, has made these changes: Raquel “Rocky” Parisi to vice president of nursing and chief nursing officer. Patricia “Trish” Sanders to vice president of operations and chief operating officer.

Melanie Campbell to vice president of institutional advancement, philanthropy and community engagement for Mercy College of Health Sciences in Des Moines, Iowa. The college is part of Trinity Health.

Grants

Among the recipients of federal funds from the omnibus bill President Joe Biden signed Dec. 29 are three ministry members: Holy Name of Teaneck, New Jersey, has received a $3.3 million federal appropriation to launch a graduate medical education program. Holy Name plans to use the funding to train 90 doctors per year in clinical specialties including internal medicine, psychiatry, general surgery, obstetrics and gynecology, orthopedics, nephrology, and palliative care. The money will fund the purchase of equipment for the residency program and pay for some facility renovations. The residency program will launch in 2025.

Marian Regional Medical Center in Santa Maria, California, has received $1 million in federal funding in support of an obstetrics and gynecology residency program clinic Marian is opening this spring. The money will help cover the costs associated with medical equipment and construction fees for the clinic. The clinic will provide prenatal and postpartum care, birthing education, lactation support, counseling programs, women’s preventive care, and management for acute and chronic gynecologic conditions. The clinic will primarily serve low-income women. It will have full-time Spanish and Mixteco translators. Marian is part of CommonSpirit Health.

St. Joseph Healthcare of Bangor, Maine, was awarded $708,000. The facility will use the funds to upgrade mammogram equipment.

Construction

Trinity Health Michigan plans to build a replacement hospital at its campus in Brighton. Inpatient and outpatient services will be relocated from the aging Trinity Health Livingston hospital in Howell to Trinity Health Medical Center – Brighton. Construction begins later this year on the four-story, 174,000-square-foot hospital. It will have 56 acuity-adaptable beds, 18 short stay unit beds, and eight operating rooms. The existing Brighton facility also will be renovated. The three-year construction project will cost about $238.2 million.

T a k e y o u r p a ss i o n f o r a d v o c a c y t o a l l l e v e l s o f h e a l t h c a r e pancreas transplants from COVID-positive donors have been done at Loyola University Medical Center without any cases of infection transmission. Recipients of the organs have fared as well as those whose donors did not test positive for COVID, she says.

“If you ask, ‘Is the organ worse because of the COVID?’” García-Roca says, “we haven’t seen any difference whatsoever.”

The Loyola transplant team’s protocols for the use of organs from COVID-positive patients include informing patients when an available organ is from a donor who has tested positive for the virus. Patients choose whether to accept the transplant. After their surgery, recipients are tested for COVID three days after the transplant and again four days later.

Even with the COVID-positive donors added to the pool, García-Roca points out that the need for organs outpaces demand. “We are all trying to optimize and maximize all types of donors,” she says of transplant centers. “Even with all the strategies that we do, still, there’s a lot of people that are sitting on the waiting list and who actually die waiting for an organ.”

The Health Resources & Services Administration, part of the U.S. Department of Health and Human Services, says 17 people die every day in the United States waiting for a transplant.

Neither Loyola nor Baylor St. Luke’s is using COVID-positive organs for lung transplants as they await more evidence on the safety of such transplants. In its report, the Ad Hoc Disease Transmission Advisory Committee of the Organ Procurement & Transplantation Network says of COVIDpositive lung transplants: “The only confirmed donor-derived transmissions have been through the airway; demonstration of non-airway transmission has not been confirmed at this time.”

Experience has benefits

More than a year after its start, Goss says Baylor St. Luke’s integration of COVIDpositive organs into the hospital’s transplant supply continues to go smoothly. Lonnie Dunlap, the recipient of the first COVID-positive transplant at the medical center, is an example of its success. Dunlap passed the first anniversary of his life with a new liver in November.

Before his transplant, Dunlap’s health had been slipping since his liver began to fail in 2017. His condition left him bloated and in need of weekly procedures to remove fluid that filled his abdomen. He now sends Goss and others on the team that did his transplant pictures of himself deep sea fishing for yellowfin tuna. “He’s doing great,” Goss says.

Part of Baylor St. Luke’s COVID protocol is to ask all organ recipients to stay up to date on their vaccinations for the virus before transplant. After the surgery, the patients are screened for symptoms of the virus for three weeks.

The doctor points out that, over its long history of organ transplantation, Baylor St. Luke’s has adopted protocols to keep organ recipients safe from many viral contagions, including herpes simplex, Epstein-Barr and other coronaviruses.

“That’s been a benefit to the entire transplant system, having to work with viruses for years already,” Goss says. “It wasn’t too much of a stretch to adopt a protocol for COVID patients as well.”