Renal transplantation during the SARS‐CoV‐2 pandemic in the UK: Experience from a large‐volume center

Abstract

There is uncertainty about the safety of kidney transplantation during the SARS‐CoV‐2 pandemic due to the risk of donor transmission, nosocomial infection and immunosuppression use. We describe organ donation and transplant practice in the UK and assess whether kidney transplantation conferred a substantial risk of harm. Data from the UK transplant registry were used to describe kidney donation and transplant activity in the UK, and a detailed analysis of short‐term, single‐center, patient results in two periods: during the pre‐pandemic era from 30th December 2019 to 8th March 2020 (“Pre‐COVID era”) and the 9th March 2020 to 19th May 2020 (“COVID era”). Donor and recipient numbers fell by more than half in the COVID compared to the pre‐COVID era in the UK, but there were more kidney transplants performed in our center (42 vs. 29 COVID vs. pre‐COVID respectively). Overall outcomes, including re‐operation, delayed graft function, primary non‐function, acute rejection, length of stay and graft survival were similar between COVID and pre‐COVID era. 6/71 patients became infected with SARS‐CoV‐2 but all were discharged without critical care requirement. Transplant outcomes have remained similar within the COVID period and no serious sequelae of SARS‐CoV‐2 infection were observed in the peri‐transplant period.

COVID-19 pandemic and worldwide organ transplantation: a population-based study

“…1,2 Despite the urgent need for many waitlisted patients worldwide to receive transplants, preliminary data suggest substantial reductions in transplantation procedures in some countries since the COVID-19 outbreak. [3][4][5][6][7][8][9][10][11] However, there is a paucity of available data concerning the effects of the pandemic on worldwide transplantation rates and how transplantation policies have changed in response to risk of infection and death associated with COVID-19. [12][13][14] The consequences of COVID-19 are not only due to infectious deaths but also the impact of the pandemic on diverse health-care services, including disruptions to or delays in cancer treatment.…”

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

“…Most transplant centers suspended their activities during the peak of the pandemic for safety issues as well as the ICU bed shortage. The mortality rate among SARS-CoV-2-positive candidates for transplant was 10.2% [5]. However, as Georgiades et al reported [5], transplant outcomes remained similar, with no difference in the rates of delayed graft function, acute rejection, reoperation, or length of hospital stay during the pandemic compared to the pre-pandemic era, and no serious sequelae of COVID-19 among transplant recipients were noticed.…”

“…The overwhelming burden of the COVID-19 pandemic for healthcare systems has affected all aspects of medical practices. Several reports demonstrated significant decreases in solid organ donation and transplantation worldwide secondary to the ongoing COVID-19 pandemic [5][6][7]. Most transplant centers drastically reduced their activity.…”

Impact of COVID-19 on Global Kidney Transplantation Service Delivery: Interim Report

“…In the US, living-donor programs paused (some for several months): kidney transplant volume was at 97.5% in 2020 compared with 2019, with an increase in deceased donors but fewer living donors ( 1 , 2 , 6 ). In the UK, all five London centers stopped kidney transplantations for months, although some regional centers continued operating ( 7 ). European participants reported no changes in recipient-selection protocols.…”