Graft Survival in Kidney Transplant Recipients During the 2024 Floods in Rio Grande do Sul: A Retrospective Cohort...

The floods that devastated southern Brazil in 2024 constituted a humanitarian crisis of historic proportions and significantly restricted access to transplant care services. This study evaluated the impact of this event on renal function and survival among kidney transplant recipients.

We conducted a retrospective cohort study including kidney transplant recipients with scheduled outpatient visits between May 3 and May 30, 2024. Patients were categorized as having attended appointments, had at least one visit rescheduled, or received remote care. Renal function was assessed using serum creatinine and estimated glomerular filtration rate (eGFR) calculated by the CKD-EPI equation. Acute rejection episodes, hospitalizations, and patient and graft survival were recorded.

Sixty kidney transplant recipients were included. Mean serum creatinine improved 6 months after the floods compared with the pre-flood period (1.57 ± 0.65 vs 1.68 ± 0.67 mg/dL; p = .025), as did eGFR (56.8 ± 24.2 vs 52.6 ± 22.0 mL/min; p = .019). Fifty patients had appointments rescheduled (mean delay 3.9 ± 2.1 months), and 6 received teleconsultations. Over 1 year, 5 acute rejection episodes, one graft loss due to rejection, and one death due to neoplasia were observed. Follow-up interval was not correlated with changes in renal function at 6 months (r = -0.108; p = .41).

Despite restricted healthcare access during the floods, kidney transplant recipients did not experience deterioration in renal function. Coordinated multidisciplinary care and proactive patient outreach may have contributed to these outcomes.