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

Abstract

SARS-CoV-2 is still a major threat to the world. In this pandemic, transplantation activities have largely been affected worldwide. We are still facing with this pandemic; however, after regulations, we have started our transplantation activities. We report the first kidney transplantation whose recipient and living donor recovered from COVID-19. A 31-year-old male with renal failure was admitted for transplantation with an ABO-compatible relative. The recipient and the donor were tested for COVID-19 before transplantation, and they were both positive with a polymerase chain reaction. The recipient had minor symptoms and received therapy; the living donor also received therapy. Thirty days after recovery, surgery was performed successfully. The recipient was discharged with mycophenolate mofetil (MMF), tacrolimus, and steroid 15 days after surgery. In the follow-up, they were both negative for COVID-19 45 days after surgery. Although there is missing literature regarding safety concerns and short-term follow-up, living-donor transplantation may be considered for patients, who recovered from COVID-19, after careful selection with paying attention to precautions.

Solid Organ Transplantation From SARS-CoV-2–infected Donors to Uninfected Recipients: A Single-center Experience

“…There are also reports of at least 45 kidneys, 14 livers, and 6 hearts transplanted from 55 donors with fully resolved SARS-CoV-2 infection with no evidence of virus transmission. 8,9,[19][20][21][22][23][24][25][26] The OPTN's recent guidance, reflecting this sparse data, concludes that the precise virus transmission risk with this transplantation strategy remains unknown and that transplantation decisions should balance this unknown risk against the recipient's morbidity and mortality risk while awaiting transplantation. 6 Our case series of 7 organ transplants contributes to the literature supporting the safety of solid organ transplantation from infected donors to uninfected recipients.…”

Transplantation of organs from SARS‐CoV‐2‐positive donors: Preliminary experience from Spain

“…1 Ideally, samples should be taken from the lower respiratory tract (which becomes mandatory in the case of lung or intestine donation and in donors with pneumonia) within 24 h prior to organ recovery. Nonstandard risk donors are defined as those with a documented history of COVID-19 fulfilling at least one of the following criteria: (i) less than 15 Antiviral prophylaxis or the preemptive use of monoclonal antibodies targeting the SARS-CoV-2 spike is not recommended. Recipients must be monitored by nasopharyngeal SARS-CoV-2 PCR on days 3 and 7 after transplantation and outcomes be reported to the ONT at 1 month after the surgery.…”

“…2,3 Second, there is growing experience on the utilization of organs other than lungs obtained from SARS-CoV-2 PCR-positive donors, without adverse reactions having been described that could be attributable to the donort's condition. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Finally, the extensive vaccination programs for SARS-CoV-2 among the general population and patients on the waiting list and the advent of therapeutic options for COVID-19 have provided a more favorable scenario for the transplantation of organs from donors who test positive for SARS-CoV-2. Indeed, the use of this organ donor pool has been progressively implemented in Spain following national guidance.…”

Solid Organ Transplantation in SARS-CoV-2 Recovered Transplant Candidates: a Comprehensive Review of Recent Literature

“…A total of 115 kidney transplants in patients who have recovered from COVID have been reported. The first case of living donor kidney transplantation (LDKT) where both donor and recipient recovered from COVID-19 illness was reported in Turkey in February 2021 [ 11 ]. Over follow-up of 45 days, the authors reported no complications in the donor-recipient pair.…”