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Kidney Transplantation and COVID-19: Two Case Reports
Sabri Tekin1, Hatice Özdoğan2, Mustafa Kemal Demir3
1Department of Organ Transplantation, Faculty of Medicine, Bahcesehir University, İstanbul, Turkey.
Transplantation Proceedings
|January 16, 2021
Summary
Treatment of kidney transplant recipients with COVID-19 is challenging. This study highlights the importance of adjusting immunosuppression and using glucocorticoids, showing potential for improved outcomes in these immunocompromised patients.
Area of Science:
- Nephrology
- Infectious Diseases
- Immunology
Background:
- Immunocompromised patients, including kidney transplant recipients, face severe risks from COVID-19.
- Established treatment guidelines for COVID-19 in kidney transplant recipients are lacking.
Observation:
- Two kidney transplant patients diagnosed with COVID-19 shortly after surgery were treated.
- Both patients were on triple immunosuppressive therapy (tacrolimus, mycophenolate mofetil, prednisone).
- Immunosuppression was reduced (MMF stopped, tacrolimus dose decreased) upon COVID-19 diagnosis.
Findings:
- One patient died due to comorbidities despite antiviral and antibiotic treatment.
- The second patient recovered from COVID-19 pneumonia with methylprednisolone, MMF, and antivirals, alongside reduced immunosuppression.
- Glucocorticoid use was associated with decreased mortality in COVID-19 treatment.
Implications:
- This case series highlights the critical need for tailored COVID-19 treatment protocols for kidney transplant recipients.
- Adjusting immunosuppressive therapy and incorporating glucocorticoids may be beneficial in managing COVID-19 in transplant patients.
- Further research is warranted to establish optimal therapeutic strategies for this high-risk group.
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