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Transplant patients getting life-saving care amid COVID-19

Performing solid organ or heart transplants in the best circumstances is serious business. Add the threat of a highly contagious virus, and transplant surgery becomes a monumental task. Despite this, Yale New Haven Hospital patients are receiving life-saving organs amid the COVID-19 pandemic.

“It isn’t exactly business as usual, but we are still performing these procedures,” said Francine LoRusso, RN, vice president and executive director, Heart and Vascular, Transplantation and Medicine services. “Because these patients go on anti-rejection medications after surgery, they become highly immunocompromised. That has forced us to be extremely selective as we move forward.”

While certain types of surgeries were canceled shortly after the pandemic began, YNHH explored ways to continue transplant procedures. The hospital temporarily halted living-donor organ transplants to reduce the risk of donors’ exposure to the COVID-19 virus, but continues to perform deceased-donor organ transplants in certain cases.

David Mulligan, MD, section chief, Yale New Haven Health Transplantation Surgery and Immunology, said weighing patients’ potential exposure to the COVD-19 virus against the seriousness of their illness is critical when deciding which cases are postponed.

“We have developed priorities based on urgency and reduced our deceased-donor transplants to only the most serious cases,” he said. “These are cases where the risk of COVID-19 is less than the risk of postponing the transplant, because the patient may not survive until the next organ becomes available.”

Pre-surgical visits and consultations have also been impacted, with nearly all performed virtually using telehealth. Patients come in to be seen only if there is a drastic clinical change or some other clinical need, said Kara Ventura, APRN, patient services manager, Transplant Services.

“A lot of these patients are so limited in their mobility that just getting to the hospital is a challenge,” she said. “They’re scared to leave the house, so we reassure them that we’re here, virtually, if they need us, and we will bring them into the hospital only if necessary. Patients really appreciate that.”

Despite COVID-19-related challenges, Sharon Klein, clinical program director, Transplantation Services, said the service line continues to care for patients after discharge.

“Once you’re transplanted you receive care for the rest of your life because of your immunosuppressive therapy,” Klein said. “With these patients being at higher risk for COVID-19, we are working closely with them to help them through this period.”

LoRusso praised the work of the entire Transplantation Services team, saying their experience and collaborative culture are paying dividends.

“We’re really fortunate to have a veteran group working in this service line,” she said. “It’s such a multidisciplinary team, and each discipline is critical. We have Pharmacy, Social Work, Nursing, coordinators and physician leaders all working together, and doing a tremendous job of coming up with ways to help our patients during this crisis.”