UW Health to require COVID vaccine before organ transplant consideration
MADISON, Wis. - UW Health will require individuals being added to its organ transplant waitlist or to receive a transplant to be vaccinated against COVID-19, the organization announced Thursday, Nov. 11.
Effective Nov. 15, the policy will apply to individuals currently being evaluated for transplant and those who are currently on the waitlist and awaiting an organ offer.
Transplant candidates who are currently active on the UW Health Transplant Center waiting list will have until December 15, 2021 (30 days) to obtain the first dose of the vaccine series, and an additional 30 days to obtain the second injection, as needed based on the vaccine manufacturer’s direction. Patients on the waitlist will be changed to an "inactive status" on January 14, 2022, if documentation of vaccination is not received.
While inactive, patients will not receive organ offers and will not be candidates to proceed to living donor transplant, even if a living donor has been identified, a release said. The patient will return to an "active status" after the appropriate timeframe following completion of the vaccine series, which is typically 14 days after the last injection.
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Individuals who are currently being evaluated for transplant, or plan to be, will need to obtain vaccination prior to being added to the waitlist. If individuals choose not to comply with the vaccination requirement, they have the right to be evaluated by another transplant center.
Patients who are deemed too ill to wait for the completion of the vaccination process can proceed to waitlisting and/or transplant with the acknowledgment of the increased risk of severe COVID-19 infection. In these cases, vaccination will be required after transplant surgery as soon as recommended by their medical team, according to a release.
"This new policy reflects our commitment to patient safety and our respect for the donors and families who’ve made the selfless decision to give others the gift of life," said Dr. Dixon Kaufman, medical director of the UW Health Transplant Center. "It is unfortunate that transplant recipients—because of the anti-rejection drugs they need—are put at far greater risk than others for severe illness or death from COVID-19. We believe that requiring vaccination for COVID-19, just as vaccinations are required for other infectious diseases, gives our recipients the best odds for surviving and thriving once they receive their transplant."
Pre- and post-transplant vaccination against a wide spectrum of diseases has been routine practice within the transplant field for years. The medications required for successful transplantation diminish antibody responses (compared to the general population) to vaccinations, and COVID-19 is no exception.
The COVID-19 pandemic has been exceptionally challenging for transplant patients because of their reduced ability to fight the disease. In one study of 482 unvaccinated transplant recipients who contracted the SARS-CoV2 virus (the virus that leads to COVID-19) 78% had to be hospitalized. Of those that needed to be hospitalized, 20.5% died, a release said.
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Patients will also be strongly encouraged to get booster shots once they are eligible but waitlisting or transplant will not be delayed as long as the initial vaccine series is completed.
UW Health is also strongly encouraging COVID-19 vaccination for all living kidney and liver donor candidates. Depending on the donor’s individual medical circumstances, vaccination may be required by the medical team. This includes, but is not limited to, situations where the potential donor is already in a higher risk group for severe COVID-19 infection.
UW Health is also strongly encouraging primary caregivers of transplant patients to be fully vaccinated prior to the transplant recipient returning home after surgery. A primary caregiver is defined as the person who will assist a patient with medications and transportation and who stays with the patient for several months after transplant.
Vaccine requirements for transplant candidates was recently endorsed by the American Society of Transplant Surgeons (ASTS), the nation’s largest organization committed to advancing the art and science of transplant surgery through patient care, research, education, and advocacy.