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COVID19 Updates

Last Updated 3/25/2020 at 13.52 EST

COVID19 Testing

We have successfully processed the first 14 COVID19 tests, requested across 8 centers, including 3 STAT requests to support deceased donor transplants. So far, all test results have come back negative and all STAT tests are resulting in under 24 hours, thanks to the incredible performance of NORA and Viracor. To view a sample of a completed COVID19 test report that has been stripped of all PHI, click here.

Home Blood Draw Service

The first mobile phlebotomy blood draw has been completed, allowing the patient to avoid going to the hospital for the draw. The NKR launched the mobile phlebotomy service last week in response to the COVID19 pandemic, allowing both donors and patients to avoid hospital/local lab visits where the risk of COVID19 exposure may be greater.

Remote Donation

We have had a donor request a change to remote donation to avoid traveling to a distant city for donation surgery. This may be of interest to other donors who want to avoid COVID19 risks related to travel. Remote donation allows donors to donate their kidney at a transplant center close to them. The transplanted organ is then shipped to the recipient’s transplant center through our proven logistics systems already in place. Please contact your center liaison for more information.

STAT Deceased Donor Testing

Our partner, VRL-Eurofins, has implemented an industry solution for COVID19 testing of deceased donors across all organ systems and as of 3/19/20 VRL had 40 of the 58 OPOs on their platform. If your OPO cannot perform COVID19 testing for deceased donors, please ask them to contact VRL. OPOs should be able to provide STAT (24-hour) testing on deceased donors by leveraging the VRL solution and their existing same-day courier vendors, such as NORA, Quick, etc.

STAT Deceased Donor Organ Recipient Testing

To test the recipients of these deceased donor organs, centers can utilize the STAT option on our current COVID19 testing system, regardless of the organ being received. We have processed  STAT tests in support of deceased donor transplants within the 24-hour targeted turnaround. So far all STAT test results have been negative.

Status of Living Donor Transplant Programs

CMS recently sent out the 'CMS Adult Elective Surgery and Procedures Recommendations' clarifying their previous recommendation regarding elective surgeries. Transplants have been grouped in the category 3b with an "Action" of "DO NOT POSTPONE." For the complete recommendation, see tier 3b.

For a list of NKR Member Center living donor transplant closures, please visit the Center Listing Service by clicking here.

Test Usage

COVID19 test kits can be used to test living donors, recipients of living donor organs and potential recipients of deceased donor organs. This COVID19 test can be used across all organ systems. Centers are planning to test both donors and recipients 2-3 weeks prior to surgery and again 2-4 days prior to surgery. Viracor is ramping up to handle 150,000 tests per month and they are planning to ship another 5,000 test kits to the NKR in 1-2 weeks. We do not anticipate a shortage of test kits. To view the presentation that explains how the COVID19 testing process works from our Wednesday (3/18) network conference call, click here.

The standard test process requires the transplant center to ship the completed test kit via FEDEX Overnight shipping back to Viracor’s Kansas lab. The STAT test process requires NORA. When a STAT order is requested, an email will be sent to NORA with the center contact information. NORA will then contact the transplant center for pickup time/location and will check for commercial flights. If NORA thinks that a charter flight will be required to achieve a 24-hour turnaround, NORA will propose the price of the charter to the transplant center and must get email authorization from the transplant center for the additional cost of the charter.

Testing Process

  1. All results must be reported to the patient’s local health department.
    1. Viracor will call the patient’s DOH if they get an address for the patient.
    2. Only POSITIVE samples will be sent to the CDC, unless otherwise requested.
  2. Testing can be performed on nasal passageway collections.
  3. Sample collection can only be performed by trained healthcare providers using appropriate PPE (personal protection equipment) per CDC guidelines.
  4. Standard test samples must be sent directly via overnight courier (morning delivery) to Viracor.
    1. The NKR is not providing a return shipping label to Viracor; the Member Center is responsible for this.
    2. Viracor’s lab address is on the kit.
    3. Viracor’s Client Service’s number: 1-800-305-5198.
    4. Turnaround time for standard test results is 12-18 hours from receipt of the sample at Viracor.
  5. STAT test samples will be picked up by the NORA courier service
    1. Turnaround time for STAT test results is targeted for 24 hours (not guaranteed) from pickup of the sample. Charter flights can be ordered to expedite turnaround time.
  6. The sample must be tested within 4 days of the date/time of collection.
  7. Test results will be delivered digitally via the existing NKR serology platform.

The NKR will be holding approximately 2,000 kits in reserve so that we can immediately resupply test kits upon request. In the near term, we will ship in quantities of 10 test kits per box. To preserve available supply, we will only ship out additional test kits if a center has used at least 50% of their original shipment. For example, if a center received 10 test kits and has only run 2 tests, we will not ship more test kits. Once the center has run at least 5 tests, we will ship out additional test kits. We are expecting another shipment of 5,000 test kits from Viracor in early April.

Test Kit Components

Test Information: Coronavirus SARS-CoV-2 RT-PCR
Tube: Red Top UTM conical tube w/beads and swabs by Hardy Diagnostic
Specimen Requirements: NP swab or nasal swab
Packaging: Swabs must be packaged in own biohazard bag with absorbent sheet
Shipping: Ambient, UN3373 Category B
Platform: Qualitative RT-PCR assay
Expected Ambient Stability: Between 48-96 hours
Quantity: 1 swab per kit with 10 kits in every 1 box ordered from the NKR

Solution Costs

All COVID19 test kits sent to NKR centers the week of 3/16/2020 will be fulfilled and shipped at no charge. All COVID19 standard tests processed in the month of March will be provided at no charge. Starting on 4/1/2020 the standard tests will be billed at $250/test. COVID19 STAT tests will be billed at $1,800/test, plus the charter cost if a charter is needed and authorized. Test kits ordered after the initial shipments will be billed at $300 for a box of 10 test kits. The home blood draws are $485/request. All COVID19 solution costs will be included in your monthly NKR invoice. The NKR terms and conditions will be updated shortly to reflect all fees for the COVID19 services.

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