Two-Case Series of Heart Transplant at a Single Center in a SARS-CoV-2 Epicenter

As SARS-CoV-2 continues to challenge hospital systems, the safety of heart transplantation must be evaluated. Retrospective review of all heart recipients transplanted at a single academic medical center in a U.S. SARS-CoV-2 epicenter found two patients with non-ischemic dilated cardiomyopathy. The 34-year-old male (ejection fraction <10%) was bridged to transplant with extracorporeal membrane oxygenation and microaxial left ventricular assist device. His perioperative course was uncomplicated except for transient SARS-CoV-2 seropositivity two months post-transplant. He was asymptomatic and remained so eight months to follow. The 20-year-old female (ejection fraction 5%) was bridged to transplant with microaxial left ventricular assist device. She progresses well with SARS-CoV-2 seronegativity eight months post-transplant. Our early experience suggests that intentional recipient, donor, and provider testing, cautious organ procurement, strategic intrahospital patient organization and transport, and well-coordinated follow-up permits uninterrupted provision of this definitive therapy for heart failure without subjecting these patients to greater risk.