key: cord-1033356-qso8ewi9
authors: Kim, In-Cheol; Hwang, Ilseon; Kim, Yun Seok; Kim, Jae-Bum
title: Successful Heart Transplantation to a Fulminant Myocarditis Patient during COVID-19 Outbreak – Lessons Learned
date: 2020-05-22
journal: Korean Circ J
DOI: 10.4070/kcj.2020.0177
sha: 18d306fcafb250623b5a99d0e8fc0bff5ecc70e6
doc_id: 1033356
cord_uid: qso8ewi9

nan

The authors have no financial conflicts of interest. procurement team from the city (Daegu) where the COVID-19 outbreak was prevalent due to the concern of SARS-CoV-2 spread. Our procurement team decided to take a nasopharyngeal swab to prove negative of SARS-CoV-2 infection before the departure. After the confirmation of the negative result, successful HT could be performed. Explanted heart showed extensive myocyte damage corresponding to her grave course (Figure 3) . She was managed in the positive pressure isolation room with the complete isolation from the COVID-19 patients in the negative pressure isolation room located on the different floor. The essence of successful HT is to maintain the best level of mutual co-operation between organizations. 1) During the outbreak of COVID-19, a balanced strategy to ensure the safety of HT recipient and medical staff is crucial in the consideration of each individual circumstance (Figure 4) . [1] [2] [3] [4] [5] Figure 4 . Algorithm of the SARS-CoV-2 Test Strategy for the brain death donor and candidate for heart transplantation during COVID-19 outbreak. Brain death donors should be tested for SARS-CoV-2 infection (preferably rRT-PCR assay from upper and/or lower respiratory tract specimens). If the test result is negative, organ donation can be safely proceeded. When the heart transplantation recipient has symptoms suggesting viral infection, unknown cause of fever, or close contact history with the SARS-CoV-2 infected patients prior 14 days, test for SARS-CoV-2 infection should be performed and proceed heart transplantation when the result is negative. Members of the donor management team and the organ procurement team should apply adequate personal protective equipment. Confirmation of the negative SARS-CoV-2 result need to be ensured according to the strategy of each hospital organ procurement organization. If the symptom of SARS-CoV-2 infection is highly suggested, repeated test need to be performed for the suspicious result. SARS-CoV-2 = severe acute respiratory syndrome coronavirus-2; COVID-19 = coronavirus disease 2019; rRT-PCR = real-time reverse transcription polymerase chain reaction; PPE = personal protective equipment.

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Echocardiography showing the parasternal long axis view during the support of extracorporeal membrane oxygenation.