J o u r n a l P r e -p r o o f SPECIAL ARTICLE Recommendations on the management of the SARS-Co V-2 coronavirus pandemic (Covid-19) in kidney transplant patients Recomendaciones en el manejo de la pandemia por coronavirus SARS-CoV-2 (Covid-19) en pacientes con trasplante renal SUMMARY The SARS-CoV-2 (Covid-19) coronavirus pandemic is evolving very quickly and means a special risk for both immunosuppressed and comorbid patients. Knowledge about this growing infection is also increasing although many uncertainties remain, especially in the kidney transplant population. This manuscript presents a proposal for action with general and specific recommendations to protect and prevent infection in this vulnerable population such as kidney transplant recipients.RESUMEN La pandemia de coronavirus del SARS-CoV-2 (Covid-19) está evolucionando muy rápidamente y significa un riesgo especial para pacientes inmunosuprimidos y con comorbilidad.. El conocimiento sobre esta creciente infección también está aumentando, aunque Page 4 of 19 J o u r n a l P r e -p r o o f persisten muchas incertidumbres, especialmente en la población de trasplante de riñón. Este manuscrito presenta una propuesta de acción con recomendaciones generales y específicas para proteger y prevenir la infección en esta población vulnerable, como los receptores de trasplante de riñón. Palabras clave: Covid-19, trasplante renal, inmunodeprimido, SARS-CoV-2.

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The number of elderly patients on the waiting list (WL) for kidney transplantation (KT) has risen significantly in recent years. Because KT offers a better survival than dialysis therapy, even in the elderly, candidates for KT should be selected carefully, particularly in older waitlisted patients. Identification of risk factors for death in WL patients and prediction of both perioperative risk and long-term post-transplant mortality are crucial for the proper allocation of organs and the clinical management of these patients in order to decrease mortality, both while on the WL and after KT. In this review, we examine the clinical results in studies concerning: a) risk factors for mortality in WL patients and KT recipients; 2) the benefits and risks of performing KT in the elderly, comparing survival between patients on the WL and KT recipients; and 3) clinical tools that should be used to assess the perioperative risk of mortality and predict long-term post-transplant survival. The acknowledgment of these concerns could contribute to better management of high-risk patients and prophylactic interventions to prolong survival in this particular population, provided a higher mortality is assumed.