A Multicenter Cohort Study From India of 75 Kidney Transplants in Recipients Recovered After COVID-19. Issue 7 (July 2021)

• Record Type: Journal Article
• Authors: Kute, Vivek B.; Ray, Deepak S.; Yadav, Dinesh Kumar; Pathak, Vivek; Bhalla, Anil K.; Godara, Suraj; Kumar, Anil; Guleria, Sandeep; Khullar, Dinesh; Thukral, Sharmila; Mondal, Rabi Ranjan Sow; Jain, Manish; Jha, Pranaw Kumar; Hegde, Umapati; Abraham M., Abi; Dalal, Sonal; Patel, Himanshu; Bahadur, Madan M.; Shingare, Ashay; Sharma, Ashish; Kumar Sharma, Raj; Anandh, Urmila; Gulati, Sanjeev; Gumber, Manoj; Siddini, Vishwanath; Deshpande, Rushi; Kaswan, Kamal; Varyani, Umesh; Kakde, Shailesh; Kenwar, Deepesh B.; Shankar Meshram, Hari; Kher, Vijay;
• Is Part Of: Transplantation. Volume 105:Issue 7(2021)
• Publication Date: 2021-07
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation immunology -- Periodicals; 617.95
• DOI: 10.1097/TP.0000000000003740
• Languages: English
• ISSNs: 0041-1337

Abstract

Abstract : Background: There is limited current knowledge on feasibility and safety of kidney transplantation in coronavirus disease-19 (COVID-19) survivors. Methods: We present a retrospective cohort study of 75 kidney transplants in patients who recovered from polymerase chain reaction (PCR)–confirmed COVID-19 performed across 22 transplant centers in India from July 3, 2020, to January 31, 2021. We detail demographics, clinical manifestations, immunosuppression regimen, laboratory findings, treatment, and outcomes. Patients with a previous diagnosis of COVID-19 were accepted after documenting 2 negative severe acute respiratory syndrome coronavirus 2 PCR tests, normal chest imaging with complete resolution of symptom for at least 28 d and significant social distancing for 14 d before surgery. Results: Clinical severity in patients ranged from asymptomatic (n = 17, 22.7%), mild (n = 36.48%), moderate (n = 15.20%), and severe (n = 7.9.3%) disease. Median duration between PCR positive to transplant was 60 d (overall) and increased significantly from asymptomatic, mild, moderate, and severe disease (49, 57, 83, 94 d, P 0.019), respectively. All recipients and donors were asymptomatic with normal creatinine after surgery at a median (interquartile range) follow-up of 81 (56–117) d without any complications relating to surgery or COVID-19. Patient and graft survival was 100%, and acute rejection was reported in 6.6%. Conclusions: Prospective kidney transplant recipients post-COVID-19 can be considered for transplantation after comprehensive donor and recipient screening before surgery using a combination of clinical, radiologic, and laboratory criteria, careful pretransplant evaluation, and individualized risk-benefit analysis. Further large-scale prospective studies with longer follow-up will better clarify our initial findings. To date, this remains the first and the largest study of kidney transplantation in COVID-19 survivors. Abstract : Supplemental Digital Content is available in the text.