Strategies to keep kidney transplant alive amid the SARS-CoV-2 pandemic

Abstract

OBJECTIVE: This study aims to describe the result of the strategies adopted to maintain the transplant program amid the COVID-19 pandemic.METHODS: Since March 2020, several measures have been adopted sequentially, including the compulsory use of personal protective equipment and the real-time polymerase chain reaction testing of collaborators, symptomatic patients, potential deceased donors, candidates for recipients, and in-hospital readmissions, regardless of symptoms. The living-donor transplantation was restricted to exceptional cases.RESULTS: Among 1013 health professionals, 201 cases of COVID-19 were confirmed between March and August 2020, with no severe cases reported. In this period, we observed a 19% institutional increase in the number of transplants from deceased donors compared with that observed in the same period in 2019. There was no donor-derived severe acute respiratory syndrome virus (SARS-CoV-2) infection. Four COVID-19-positive patients underwent transplantation; after 28 days, all were alive and with functioning allograft. Among the 11,875 already transplanted patients being followed up, there were 546 individuals with confirmed diagnosis, 372 who required hospitalization, and 167 on mechanical ventilation, resulting in a 27% mortality rate.CONCLUSIONS: These data confirm that the adoption of sequential and coordinated measures amid the pandemic was able to successfully maintain the transplant program and ensure the safety of health professionals and transplanted patients who were already in follow-up.

One-year impact of COVID-19 pandemic on renal replacement therapy and kidney transplantation in a tertiary center in Southern Brazil

“…However, a very large transplant program in Brazil reported that the adoption of sequential coordinated safety measures allowed the maintenance of the transplant program. Nevertheless, the elevated mortality observed in most centers and registries also occurred in the infected population of KRT followed in this center 22 .…”

To transplant or not to transplant during a pandemic?

“…While elective living donor kidney transplants were postponed, many transplant centers persisted performing transplants with deceased donor kidneys, depending to the local impact of the pandemic on health care resources, and highly encouraged by frequent videoconferences with experts and transplant physicians promoted by the Associação Brasileira de Transplant de Órgãos (ABTO). Therefore, by the end of 2020, the overall reduction in the number of kidney transplants was only 30%, much lower than that observed in other countries 1,6 .…”

Impacto de um ano da Pandemia COVID 19 na terapia renal substitutiva e no transplante renal em centro terciário no Sul do Brasil

“…Entretanto, um amplo programa de transplante no Brasil relatou que a adoção de medidas sequenciais de segurança coordenadas permitiu a manutenção do programa de transplante. Não obstante, a elevada mortalidade observada na maioria dos centros e registros também ocorreu na população infectada de RTR acompanhada neste centro 22 .…”