No COVID vaccine? No organ transplant, Colorado hospital decides

COVID-19 Vaccine

DENVER (KDVR) — A patient on the kidney transplant list was moved to inactive status by UCHealth for not receiving a COVID-19 vaccine. Her living donor is also unvaccinated and UCHealth said both need to be vaccinated for the transplant process to continue. 

The letter Leilani Lutali received states: “The transplant team at University of Colorado Hospital has determined that it is necessary to place you inactive on the waiting list. You will be inactivated on the list for non-compliance by not receiving the COVID vaccine. You will have 30 days to begin the vaccination series. If your decision is to refuse COVID vaccination you will be removed from the kidney transplant list. You will continue to accrue waiting time, but you will not receive a kidney offer while listed inactive. Once you complete the COVID vaccination series you will be reactivated on the kidney transplant list pending any other changes in your health condition.”

Lutali said she has religious concerns with the vaccines, as well as concerns that the vaccine would not be effective after receiving immunosuppressant drugs post-surgery.

“Both from a religious standpoint, and from doing some reading, I’m not certain that this is the right way to go,” she said. “The shot’s relatively new, and as a consumer, I’m not an early adopter, I wait and see what’s going on. 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 life-saving transplant.”

Lutali’s potential donor, Jaimee Fougner, said she was also told she would not be eligible for the surgery since she is unvaccinated as well. 

“When I explained that no, I wouldn’t be able to take the COVID shot, then the comment was, well your journey ends here, because we require all of our donors and recipients to have the COVID-19 vaccine,” Fougner said. 

“I’m a strong no on the vaccine, for sure,” she said. “We’re talking about compromising my morals, for her right to have a surgery,” Fougner said, claiming religious concerns for not being vaccinated. 

UCHealth provided information regarding the process in organ transplantation:

An organ transplant is a unique surgery that leads to a lifetime of specialized management to ensure an organ is not rejected, which can lead to serious complications, the need for a subsequent transplant surgery, or even death. Physicians must consider the short- and long-term health risks for patients as they consider whether to recommend an organ transplant.

Transplant centers across the nation, including the UCHealth Transplant Center, have specific requirements in place to protect patients both during and after surgery. For example, patients may be required to receive vaccinations including hepatitis B, MMR and others. Patients may also be required to avoid alcohol, stop smoking, or prove they will be able to continue taking their anti-rejection medications long after their transplant surgery. These requirements increase the likelihood that a transplant will be successful and the patient will avoid rejection.

In almost all situations, transplant recipients and living donors at UCHealth are now required to be vaccinated against COVID-19 in addition to meeting other health requirements and receiving additional vaccinations. Some U.S. transplant centers already have this requirement in place, and others are making this change in policy now. 

Patients who have received a transplanted organ are at significant risk from COVID-19. Should they become infected, they are at particularly high risk of severe illness, hospitalization and death. Studies have found transplant patients who contract COVID-19 may have a mortality rate of 20% or higher. A living donor could pass COVID-19 infection on to an organ recipient even if they initially test negative for the disease, putting the patient’s life at risk.

One broad study found kidney transplant patients who contracted COVID-19 had a 21% mortality rate. Other studies found mortality rates ranging from 18% to 32% for transplant recipients who acquired COVID-19. For comparison, the CDC says the current mortality rate for everyone who has tested positive is 1.6%. This is why it is essential that both the recipient and the living donor be vaccinated and take other precautions prior to undergoing transplant surgery. Surgeries may be postponed until patients take all required precautions in order to give them the best chance at positive outcomes.

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