Kidney transplantation in patients recovered from Coronavirus disease 2019

Abstract

Objective: There is limited information about kidney transplant recipients who recovered from the Coronavirus disease 2019. This study is conducted to investigate the safety of transplantation in this patient population. Methods: Nineteen patients with prior coronavirus disease 2019 were included. We present demographics, clinical characteristics, laboratory findings, and immunosuppressive regimen. Graft functions and patient and allograft outcomes were compared to 19 kidney transplant recipients who did not have coronavirus disease 2019. Results: The median age of participants was 38 (interquartile range, 26-51) years. Most of the recipients were men (n = 30, 78.9%). The most common presenting symptoms of kidney transplant recipients with prior coronavirus disease 2019 were fever (36.8%), fatigue (21.1%), dyspnea (15.8%), cough (10.5%), and myalgia (5.3%). Eight patients (42.2%) were hospitalized, while none required intensive care unit admission and mechanical ventilation. The median wait time for transplantation after the initial diagnosis of coronavirus disease 2019 was 82 days (interquartile range, 57-172). Most recipients in both groups received antithymocyte globulin as an induction agent. Standard doses of maintenance immunosuppression consisting of tacrolimus, mycophenolate derivatives, and corticosteroids were administered. During a follow-up duration of 85 (interquartile range, 39-154) and 134 (interquartile range, 56-240) days for patients and controls, respectively, the rate of complications and graft functions were not statistically significant between groups. Graft and patient survival was 100%. Conclusion: Our study results support the safety of kidney transplantation in patients with prior coronavirus disease 2019. Transplant candidates and donors should be carefully screened for coronavirus disease 2019. We suggest continuing the standard doses of induction and maintenance immunosuppression, especially in patients who recovered without pulmonary sequelae.