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Heterotopic Renal Autotransplantation in a Porcine Model: A Step-by-Step Protocol
Published on: February 21, 2016
Kidney transplantation during coronavirus 2019 pandemic at a large hospital in Miami
Aditya Chandorkar1, Ana Coro1,2, Yoichiro Natori1,2
1Division of Infectious Disease, Department of Medicine, University of Miami Miller School of Medicine Miami, Miami, FL, USA.
Insights
Deceased donor kidney transplants (DDKT) can be safely performed during the COVID-19 pandemic. Implementing preventive measures is crucial for successful kidney transplantation outcomes and patient survival.
Area of Science:
- Nephrology
- Transplantation Surgery
- Infectious Diseases
Background:
- The COVID-19 pandemic caused a significant global increase in mortality and a decline in kidney transplantations.
- This study focuses on the experience of deceased donor kidney transplantation (DDKT) during the pandemic.
Purpose of the Study:
- To evaluate the safety and outcomes of deceased donor kidney transplantation (DDKT) during the COVID-19 pandemic.
- To assess the effectiveness of implemented preventive measures in kidney transplant recipients.
Main Methods:
- A retrospective study analyzed adult patients undergoing DDKT between March 1, 2020, and April 30, 2020.
- Data collected included donor and recipient COVID-19 status, and post-transplant outcomes such as infections, readmissions, rejection, and mortality.
- Preventive measures were implemented for all procedures.
Main Results:
- Seventy-six kidney transplants were performed from 57 donors; donor and recipient SARS-CoV-2 testing was largely negative.
- Post-transplant follow-up showed no COVID-19 infections in recipients, with one inconclusive test later confirmed negative.
- While 52.6% of recipients were readmitted and 9.2% experienced rejection, no transplant recipients died during the follow-up period.
Conclusions:
- Deceased donor kidney transplantation is a safe procedure during the COVID-19 pandemic.
- The implementation of comprehensive preventive strategies is key to ensuring successful DDKT outcomes and patient safety.
Background:
Coronavirus 2019 (COVID-19) pandemic has resulted in more than 350 000 deaths worldwide. The number of kidney transplants has declined during the pandemic. We describe our deceased donor kidney transplantation (DDKT) experience during the pandemic.
Methods:
A retrospective study was conducted to evaluate the safety of DDKT during the COVID-19 pandemic. Multiple preventive measures were implemented. Adult patients that underwent DDKT from 3/1/20 to 4/30/20 were included. COVID-19 clinical manifestations from donors and recipients, and post-transplant outcomes (COVID-19 infections, readmissions, allograft rejection, and mortality) were obtained. The kidney transplant (KT) recipients were followed until 5/31/20.
Results:
Seventy-six patients received kidneys from 57 donors. Fever, dyspnea, and cough were reported in 1, 2, and 1 donor, respectively. Thirty-eight (66.6%) donors were tested for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) prior to donation (mainly by nasopharyngeal or bronchoalveolar lavage polymerase chain reaction [PCR]) and 36 (47.3%) KT recipients were tested at the time of DDKT by nasopharyngeal PCR; all of these were negative. Our recipients were followed for a median of 63 (range: 33-91) days. A total of 42 (55.3%) recipients were tested post-transplant for SARS-CoV2 by nasopharyngeal PCR including 12 patients that became symptomatic; all tests were negative except for one that was inconclusive, but it was repeated and came back negative. Forty (52.6%) KT recipients were readmitted, and 7 (9.2%) had biopsy-proven rejection during the follow-up. None of the KT recipients transplanted during this period died.
Conclusions:
Our cohort demonstrated that DDKT can be safely performed during the COVID-19 pandemic when preventive measures are implemented.
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