Why Unvaccinated Patients Are Being Removed From Organ Transplant Waitlists

Donated organs available for transplant remain scarce. 

Doctors and hospitals do not want to waste them on people who are - by their own choice - at considerably higher risk of death due to Covid. JL 

Beth Mole reports in ars technica:

A growing number of medical facilities across the country are directing coveted organ donations to patients who have been vaccinated against COVID-19, pushing people who remain unvaccinated down or even off of transplantation waitlists. The thinking behind this move is simple: with transmission of the pandemic coronavirus still high in the US, unvaccinated transplant candidates face an extremely high risk of COVID-19, which poses a danger to them and imperils the usefulness of the scarce, life-saving organs.

A growing number of medical facilities across the country are directing coveted organ donations to patients who have been vaccinated against COVID-19, pushing people who remain unvaccinated down or even off of transplantation waitlists.

The thinking behind this move is simple: with transmission of the pandemic coronavirus still high in the US, unvaccinated transplant candidates face an extremely high risk of COVID-19, which poses a danger to them and imperils the usefulness of the scarce, life-saving organs.

Receiving a transplanted organ requires patients to take immunosuppressant drugs that will prevent their bodies from rejecting the new organ as foreign. But this immune suppression also makes the recipients highly susceptible to becoming infected with the pandemic coronavirus, SARS-CoV-2, and developing severe COVID-19. Some experts estimate that transplant recipients' risk of dying from COVID-19 is as high as 20 to 30 percent.

Odds of survival have long been factored into prioritizing who will get donated organs. And requiring vaccinations against devastating infectious diseases is also standard. Organ recipients are already generally required to be vaccinated against hepatitis A, hepatitis B, influenza, and tetanus, among other diseases.

Uproar

Still, COVID-19 vaccines, which are newly approved by the Food and Drug Administration, are fresh to the lists. On August 13, the American Society of Transplantation and the International Society for Heart and Lung Transplantation (ISHLT) released a joint statement recommending that "all solid organ transplant recipients should be vaccinated against SARS-CoV-2," as should "all eligible household and close contacts" of those recipients. More and more transplant programs are adopting the policy—but not yet all.

Advertisement

The reality of unvaccinated patients getting kicked off some organ waitlists recently made headlines with the story of an unvaccinated Colorado woman named Leilani Lutali. UCHealth in Denver denied Lutali's kidney-transplant surgery because she was unvaccinated and informed her in a letter that she would be listed as "inactivated" on a kidney-transplant waiting list if she didn't get a first vaccine dose within 30 days. Lutali, who told the Associated Press that she is a born-again Christian without a denomination, says she objects to the vaccines on religious grounds. With the national patchwork of vaccine requirements for transplant patients, Lutali is now seeking a transplant in another state, such as Texas or Florida, in facilities that do not require COVID-19 vaccination.

"I feel like I'm being coerced into not being able to wait and see and that I have to take the shot if I want this lifesaving transplant," Lutali told Kaiser Health News.

The outlet noted that there are nearly 107,000 people waiting for organs in the US—more than 90,000 of them are, like Lutali, waiting for a kidney. Dozens of people in need of various organs die each day while waiting, KHN reported.

"We mandate hepatitis and influenza vaccines, and nobody has an issue with that," Dr. Kapilkumar Patel, director of the lung transplant program at Tampa General Hospital in Florida, told KHN. "And now we have this one vaccination that can save lives and make an impact on the post-transplant recovery phase. And we have this huge uproar from the public."