Solid Organ Transplantation in the Coronavirus Disease 2019 Era: "The Great Bet" in the North Italy Transplant Program Area

Transplant Proc. 2020 Nov;52(9):2631-2636. doi: 10.1016/j.transproceed.2020.07.001. Epub 2020 Jul 7.

Abstract

Introduction: Solid organ transplantation is challenging for waitlist patients during the coronavirus disease 2019 (COVID-19) pandemic.

Aim: This study investigates COVID-19 incidence and mortality in patients transplanted in the North Italy Transplant program (NITp) during the outbreak.

Materials and methods: All consecutive patients transplanted from February 20 to April 3, 2020 (6 weeks), were included in our cohort and were observed for at least 4 weeks. Survival analyses were performed.

Results: In this study, 124 patients were transplanted with 12 (9.7%) hearts, 4 (3.2%) lungs, 39 (31.4%) livers, 67 (54%) kidneys, and 2 (1.6%) combined kidney-pancreas. Recipients' mean age was 51 years (standard deviation [SD] ± 16.6), and 76 of 124 (61%) were men. Five (4%) patients developed COVID-19 after a mean of 13 days (SD ± 6.7), with a cumulative incidence of 4.0% (95% confidence interval [CI], 0.5-7.5). During the follow-up period, 5 of 124 (4%) recipients died; overall mortality was 4.3% (95% CI, 0.6-8.0), with only 1 patient dying of COVID-19, for a COVID-19-related mortality of 0.8% (95% CI, 0-6.0).

Conclusions: This study showed a low COVID-19 incidence and COVID-19-related mortality in patients transplanted during the COVID-19 pandemic. Further studies with a longer follow-up period are mandatory to confirm the safety of transplant procedures.

MeSH terms

  • Adult
  • Betacoronavirus*
  • COVID-19
  • Cohort Studies
  • Coronavirus Infections / mortality*
  • Female
  • Humans
  • Incidence
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Organ Transplantation / mortality*
  • Pandemics
  • Pneumonia, Viral / mortality*
  • Postoperative Complications / mortality*
  • Postoperative Complications / virology
  • SARS-CoV-2
  • Survival Analysis
  • Waiting Lists / mortality