- Conducting an adequate screening for possible transplant recipients is more important than ever
- The American Society of Transplantation requires at least 1 nucleic acid test be performed for COVID-19 in all screening patients
- Due to lack of data, there are still no definitive recommendations regarding modification of immunosuppression in non-infected kidney transplant recipients
- Telemedicine will be essential for post operation patients as it minimizes a lot of normal risk associated with going to a transplant center


Ohio State University, Columbus

- This article discusses the impact of COVID-19 on kidney transplantation 
- It also provides a more in-depth explanation into some of the specifics of what effect COVID-19 had on kidney transplants, some guidelines for donor testing, the prevalence of COVID-19 in transplant recipients, and some general guidelines regarding minimizing infection risk in patients


The impact of COVID-19 on kidney transplantation

Alasfar, S., & Avery, R. K. (2020). The impact of COVID-19 on kidney transplantation. Nature reviews. Nephrology, 16(10), 568–569. https://doi.org/10.1038/s41581-020-00340-z

URL: https://www.nature.com/articles/s41581-020-00340-z


- Initially, kidney transplants were suggested to not be postponed, however in a survey in March 2020, most transplant centers in the US had postponed procedures of live and deceased donors
- Additionally, upon reopening, transplants were only performed on individuals who were considered the most high-risk, like patients without access to dialysis
- A 2.2-fold increase in mortality of those on the waiting list for kidney transplants ensued 
- Now, researchers have assisted transplant centers by using simulations to identify who would benefit most from kidney transplantation in order to assess surgery risk


Impact on Kidney Transplant Programs

- There isn’t much research into how a COVID-19 infected donor could pass disease onto a recipient
- In order to assess donors, the American Society of Transplantation recommends all perspective donors undergo epidemiological, clinical, and laboratory assessment to determine fitness for transplantation
- Any donors with prior COVID-19 infection should be cleared via nucleic acid testing at least 24 hours apart and dissipation of symptoms 28 days prior


Donor Testing

- COVID-19 mortality among solid organ transplants varies between 6-30%
- In a case study of 90 solid organ transplant recipients, 70% reported a fever, 59% reported a cough, and 43% reported dyspnea post operation
- Many of these patients also had additional comorbidities which have been known to exacerbate COVID-19 severity
- Treating these patients is difficult as post-transplant patients must be on an immunosuppressant agent in order for their body to adequately accept the transplanted organ


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