COVID-19 and Renal Transplant: Experiences from the Past and Lesson for the Future – A Comprehensive Review

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has distorted the health-care system at a global level. Organ donation being a life-saving procedure, it continued even in the COVID era, although at a slow pace. Irrespective of the increase in renal transplants in the later era of COVID-19, the scarcity of literature for a review article in this context resulted in the genesis of this study. A retrospective data collection was conducted over various databases in the English language. The databases were thoroughly searched with keywords COVID-19, Coronavirus, SARS-CoV-2, and renal transplant. The data from various sources including original articles comprising single- and multicenter studies were collected, analyzed, and compiled over various parameters. The data were framed as mean, median, percentage, and standard deviation. We analyzed 10 single-centered studies and 4 multicenter studies conducting renal transplantation during the COVID era. The mean age of donor and recipient in the analysis was 47.6 ± 6.01 years and 47.8 ± 6.65 years, respectively. Two transplant centers used deceased renal donors only and one centre was doing transplant only on live donors and the remaining of the centres were taking both live and deceased donors. We observed that four studies had no COVID-positive recipient in their follow-up and the maximum COVID-positivity rate was 50%. Among reviewed 14 studies, 8 studies had no mortality in recipients who were COVID positive and the maximum mortality was 54%. To reduce morbidity and mortality, strict criteria for COVID-19 workup in donor and recipient patients should be followed. The type of donor has no direct relation to the risk of acquiring COVID-19 infection. The vaccination program has been accepted worldwide to reduce the severity of COVID-19 infection even in transplant patients.