The Effects of COVID-19 in Kidney Transplantation: Evidence From Tissue Pathology
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View abstract on PubMed
Summary
This summary is machine-generated.SARS-CoV-2 infection in kidney transplants does not directly damage the organ but increases the risk of rejection. Transplantation from COVID-19 positive donors is safe, with no evidence of viral transmission.
Area Of Science
- Nephrology
- Virology
- Transplantation Immunology
Background
- The direct pathological effects of SARS-CoV-2 on transplanted kidneys remain unclear.
- Limited pathological data exists regarding SARS-CoV-2 infection in kidney allografts.
Purpose Of The Study
- To evaluate the biological effects of SARS-CoV-2 infection on kidney transplant biopsies.
- To compare outcomes of kidney transplants involving donors or recipients with COVID-19 against controls.
Main Methods
- A single-center, prospective observational study of 503 kidney transplant biopsies.
- Comparison groups included deceased donors with COVID-19, recipients with SARS-CoV-2 Omicron variant, BK virus (BKV) infected samples, and uninfected controls.
- Ultrastructural analysis and molecular detection of SARS-CoV-2 were performed on renal tubules.
Main Results
- Non-viral tubular injury was observed in transplanted kidneys from infected donors and recipients; direct viral infection was excluded as a cause of damage.
- No SARS-CoV-2 particles, RNA, or cytopathic effects were detected in renal tissues.
- Post-COVID-19 recipient biopsies showed a significantly higher prevalence of rejection (33.0%) compared to uninfected controls (13.4%).
- Prior COVID-19 was an independent risk factor for subsequent transplant rejection (OR, 2.195).
Conclusions
- Transplantation from COVID-19 positive deceased donors resulted in favorable recipient outcomes without viral transmission.
- Acute kidney injury in COVID-19 was linked to tubular injury, not direct viral infection.
- SARS-CoV-2 infection is associated with an increased risk of subsequent kidney transplant rejection, similar to BK virus infection.
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