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

Clin Transplant. 2021 Jan;35(1):e14150. doi: 10.1111/ctr.14150. Epub 2020 Nov 23.

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.

Keywords: COVID-19; SARS-CoV-2; coronavirus pandemic; kidney transplantation; organ donation.

MeSH terms

  • Adult
  • COVID-19 / complications*
  • COVID-19 / immunology
  • COVID-19 / virology
  • Female
  • Graft Rejection / epidemiology*
  • Graft Rejection / immunology
  • Graft Rejection / virology
  • Hospitals, High-Volume / statistics & numerical data*
  • Humans
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Retrospective Studies
  • SARS-CoV-2 / isolation & purification*
  • Transplant Recipients / statistics & numerical data*
  • United Kingdom / epidemiology