Unvaccinated patients may be at risk of Covid and wasting organs that could be used for other purposes.
The most prominent example of the controversy roiling the nation’s 250+ organ transplant centers is the Colorado kidney transplant candidate who was inactively vaccinated against Covid-19.
A growing number of transplant programs across the country have decided to either deny patients refusing to receive the Covid vaccines from transplants or to lower priority for those on crowded organ waiting lists. Others, however, claim they do not plan to place such restrictions.
The question is whether transplant patients who refuse to take the jabs not only put themselves at risk of serious illness and death from Covid infections but also waste precious organs that could be used for other purposes. This argument is similar to the demand that patients who smoke quit for six months prior to receiving lung transplants and that addicts abstain from drinking alcohol before receiving new livers.
“It’s a matter of active discussion,” Dr. Deepali Kumar, a transplant expert at the University of Toronto and president elect of the American Society of Transplantation said. It is a decision made by each program. It’s constantly changing in many programs.
Leilani Lutali (56), a Colorado Springs patient with late-stage kidney disease, was informed by UCHealth Denver in a Sept. 28 mail that she would be losing her place on the transplant waiting lists if she did not start a Covid series within 30 days. Jaimee Fougner (45), from Peyton, Colorado refused to be vaccinated. She cited religious objections as well as uncertainty regarding the safety and effectiveness.
“I still have many questions. Lutali stated that it feels like I’m being coerced into waiting and seeing and that I must take the shot if this lifesaving transplant is to be done.
She stated that she was willing to have Covid tested before surgery and to sign a waiver exonerating the hospital from any legal liability for refusing to receive a vaccine. “At what point can you no longer be a partner in your care, regardless of your concerns?” She said.
Lutali plans to now travel to Texas to pursue her transplant journey. Several Texas hospitals, including Houston Methodist, Baylor University Medical Center, and Baylor University Medical Center, in Dallas, have said that they don’t require Covid vaccines to approve active applicants for the national waiting lists.
The national divide is evident in the stark differences between Denver’s policies and those in Texas. According to Dr. Krista Lentine, a nephrologist from Saint Louis University School of Medicine, less than 7 percent of all transplant programs reported inactivating patients who had not been vaccinated or who were partially vaccinated against Covid as of April.
Lentine stated that this was a snapshot of late spring and it is “rapidly evolving” like all Covid-related activities.
UCHealth Denver started requiring Covid vaccinations in transplant patients in late august. This was in response to the American Society of Transplantation’s August recommendation that all solid organ transplant recipients be vaccinated against SARS/CoV-2, the coronavirus responsible for Covid-19.
Patients who have undergone transplant surgery are given artificial suppression of their immune system to prevent them from rejecting new organs. Unvaccinated transplant patients are at “extreme risk” for severe illness if infected with the coronavirus. According to UCHealth spokesperson Dan Weaver Dan Weaver said that this puts them at “extreme danger” of contracting the virus. The mortality rates are between 20 and 30 percent depending on the study. Research has shown that transplant patients who have received Covid vaccines following surgery might not be able to mount strong immune reactions.
Everyone is welcome to receive the hepatitis or influenza vaccines.
According to Dr. Ajit Limaye of UW Medicine, Seattle, Covid vaccinations were mandated this summer. To be eligible for transplantation, patients had to meet additional criteria, such as receiving vaccines against influenza and hepatitis B.
He said, “For anyone who doesn’t have a medical contraindication we’re basically requiring it.” “There is a strong sense that it should be a requirement. It’s like all the hoops.
Northwestern Medicine in Chicago, which performed the first double lung transplant on a Covid patient, in June 2020, is encouraging, but not requiring, vaccination against Covid-19.
Jenny Nowatzke (Norwegian’s manager of national media relations), stated that they don’t deny transplant care based on vaccination status. “The patient doesn’t also get lower scores.”
According to Dr. Kapilkumar Ptel, who directs the Tampa General Hospital’s lung transplant program, there is no need for Covid vaccinations because of inconsistent practice.
He said, “We mandate hepatitis vaccines and influenza vaccines. And nobody has an issue about that.” “And now, we have one vaccine that can save lives and impact the post-transplant recovery period. We have huge outcry from the public.”
Nearly 107,000 people are still waiting in the U.S. for organs; many more die each day. Transplant centers assess which patients can be added to the national transplant list. They take into consideration medical criteria as well as other factors such financial resources and social support. This helps to ensure that organs don’t go to waste.