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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
PubMed

Insights

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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