- 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


COVID-19 in Transplant Recipients

- 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


Minimizing Infection Risk in Patients

- 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


Ohio State University, Columbus

- Mitigating Risk of COVID-19 in Dialysis Facilities
- The impact of COVID-19 on kidney transplantation

Changes to Treatment and Communication Related to Renal Diseases in the COVID-19 Era

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


The impact of COVID-19 on kidney transplantation

- This paper provides some general guidelines which should be in place for dialysis facilities during the pandemic which have been provided by the American Society of Nephrology
- Some of the areas of care which this paper touches on include patient screening and placement, protection protocol for staff and patients, as well as communicative measures for these facilities to take


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