Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia.
Med Hypotheses. 2020 Nov;144:109903. doi: 10.1016/j.mehy.2020.109903. Epub 2020 May 31.
Information on treatment of COVID-19 infection in renal transplant recipients is scarce, especially in symptomatic patients and patients with recent major clinical events. This group of patients suffers from different opportunistic infections which may coexist with COVID-19. Currently available expert opinions suggest reduction of immunosuppression therapy for renal transplant recipients with symptomatic COVID-19 infection with either antiviral drugs, hydroxychloroquine and/or azithromycin. Inspired by our experience in treatment of CMV pneumonia and literature data on the potential benefit of convalescent plasma for treatment of different viral diseases we suggest use of the hyperimmune anti-CMV gamma globulins in addition to other available therapies. Besides the immunosuppression reduction which is supposed to be beneficial, immunoglobulins with their immunomodulatory effects and possible antiviral role, may increase a possibility for favorable outcome.
有关肾移植受者 COVID-19 感染治疗的信息很少，特别是在有症状的患者和近期发生重大临床事件的患者中。这群患者患有不同的机会性感染，可能与 COVID-19 同时存在。目前的专家意见建议，对于有症状的 COVID-19 感染的肾移植受者，使用抗病毒药物、羟氯喹和/或阿奇霉素减少免疫抑制治疗。受我们治疗 CMV 肺炎经验的启发，以及关于恢复期血浆治疗不同病毒疾病潜在益处的文献数据，我们建议在其他可用疗法的基础上使用抗巨细胞病毒γ球蛋白。除了预期有益的免疫抑制减少之外，免疫球蛋白具有免疫调节作用和可能的抗病毒作用，可能会增加有利结果的可能性。
