A transplant patient died after she received lungs that were infected with COVID-19

• A Michigan woman died of COVID-19 two months after she received a lung transplant.
• Her doctors didn't know the lungs were infected with COVID-19, initially testing negative for the disease.
• Doctors say this is the first documented case of the virus being transmitted through an organ transplant.

A Michigan woman died from COVID-19 two months after undergoing a transplant to receive a set of lungs that were carrying the disease, despite testing negative before the operation.

This is likely the first recorded case of COVID-19 being transmitted via organ donation, according to a report about the case by doctors at the University of Michigan.

"We would absolutely not have used the lungs if we'd had a positive COVID test," Dr. Daniel Kaul, lead author of the report, told Kaiser Health News. Experts say the case raises questions about how to test donor organs for COVID-19 during the pandemic.

She tested positive 3 days after the operation, and was in the ICU for 61 days

The lungs initially tested negative for COVID-19 when they were being evaluated for organ donation. The donor, a Midwest woman who died in a car accident, had no prior history of COVID-19 or other medical complications.

The woman receiving the lungs tested negative for COVID-19 12 hours before the procedure. But within three days of the procedure, she developed a fever, hypertension, and needed a ventilator.

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Her lungs tested positive for COVID-19 five days after the surgery was performed, and despite round-the-clock treatment for 61 days in the ICU, she died two months after she received the lungs.

The surgeon who collected the donor lungs for transplant also contracted COVID-19, but later made a recovery.

New testing and PPE protocols for transplants during the pandemic

Transmission of an infection or virus from a donor to an organ recipient is incredibly rare, occurring in less than 1% of all transplant cases according to the report.

However, donor-derived disease (DDD), as it is technically known, is usually deadly.

Doctors say the COVID-19 incident appears to be an unlikely and rare case, but the report raises concerns about what procedures doctors should use when testing for COVID-19 in donor organs.

The study authors suggest adding more requirements for COVID-19 testing on donor organs, such as two mandatory tests for COVID-19 for non-lung donors (one PCR test and one swab of the lungs) and a COVID-19 test of the lower respiratory tract for lung donors. The lab tests should be paired with personal questions about the donor's personal life such as if they traveled recently.

Doctors also suggest personal protective equipment (PPE) requirements are evaluated for organ donation procedures, as no N95 masks and eye protection were required for the donor organ extraction in the case study.