COVID-19 and Living Donor Kidney Transplantation in Naples during the Pandemic

Abstract

Introduction. SARS-CoV-2 is a virus that causes a potentially deadly syndrome that affects especially the respiratory tract. Kidney-transplanted patients are immunosuppressed and more susceptible to viral infections. We have examined our transplantation activity to explore the future role of kidney transplantation from deceased and living donors in COVID-19 era. Patients and Methods. The activity of our transplant center of Naples (one of the two transplant centers in Campania, South Italy) continued during the COVID-19 pandemic. We have analysed the kidney transplants carried out between March 9 and June 9, 2020, comparing these data with the numbers of procedures performed in the two previous years. Moreover, we have considered the possibility of performing living donor transplants during a worldwide pandemic. Results. From March 9, 2020, when the Italian lockdown begun, till June 9, 2020, five kidney transplants have been performed at our transplant center in Naples, all from deceased donors. The donors and the recipients have been screened for COVID-19 infection, and the patients, all asymptomatic, followed strict preventive measures and were fully informed about the risks of surgery and immunosuppression during a pandemic. All the transplanted patients remained COVID negative during the follow-up. The number of transplants performed has been constant compared to the same months of 2018 and 2019. In agreement with the patients, we decided to postpone living donor transplants to a period of greater control of the SARS-CoV-2 spread in Italy. Conclusion. Deceased donor kidney transplantation should continue, especially in a region with moderate risk, like Campania, with a more careful selection of donors and recipients, preferring standard donors and recipients without severe comorbidities. Living donor transplantation program, instead, should be postponed to a period of greater control of the SARS-CoV-2 spread, as it is an elective surgery and its delay does not determine additional risks for patients.

SARS‐CoV‐2 infection affects the lower urinary tract and male genital system: A systematic review

“…SARS‐CoV‐2 belongs to the β‐coronavirus cluster 1,5 . Entry of SARS‐CoV‐2 into host cells depends on cellular expression of both angiotensin‐converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) 1,6–10 . Zou et al analyzed the RNA sequencing datasets of cells of major human physiological systems to evaluate the expression of the ACE2 receptor and constructed a risk map of the different vulnerability of various organs to severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) 11 .…”

“…1,5 Entry of SARS-CoV-2 into host cells depends on cellular expression of both angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2). 1,[6][7][8][9][10] Zou et al analyzed the RNA sequencing datasets of cells of major human physiological systems to evaluate the expression of the ACE2 receptor and constructed a risk map of the different vulnerability of various organs to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). 11 This physiological variability is a biological background that may explain the different involvement of individual organs or tissues in the clinical presentation of COVID-19.…”

The First Kidney Transplantation After Recipient and Living Donor Recovered From COVID-19

“…In Italy, Peluso et al [ 5 ] investigated their bicentric series during the pandemic. Five patients underwent transplant surgery and all surgeries were performed from deceased donors.…”

Effects of the COVID-19 Pandemic on Solid Organ Transplantation During 2020 in Poland Compared with Countries in Western Europe, Asia, and North America: A Review

“…Insufficient evidence and long-term follow-up drive a dispute about whether transplant therapy should be continued without limitations or should be restricted to urgent cases. It seems that decisions need to be made case-by-case, according to individual risk assessment and local epidemic situation [64].…”