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在 SARS-CoV-2 大流行期间在英国进行肾移植:来自大容量中心的经验。

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

机构信息

Department of Surgery, University of Cambridge, Cambridge, UK.

Department of Transplantation, Cambridge University Hospitals, Cambridge, UK.

出版信息

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.

摘要

由于供体传播、医院感染和免疫抑制使用的风险,在 SARS-CoV-2 大流行期间,肾移植的安全性存在不确定性。我们描述了英国的器官捐赠和移植实践,并评估了肾移植是否会带来实质性的伤害风险。我们使用英国移植登记处的数据描述了英国的肾捐赠和移植活动,并对两个时期的短期、单中心、患者结果进行了详细分析:2019 年 12 月 30 日至 2020 年 3 月 8 日(“COVID 前时期”)和 2020 年 3 月 9 日至 5 月 19 日(“COVID 时期”)的大流行前时期。与 COVID 前时期相比,英国 COVID 期间的供体和受体数量减少了一半以上,但我们中心的肾移植数量增加了(分别为 42 例与 COVID 时期相比,COVID 前时期为 29 例)。COVID 和 COVID 前时期的总体结果(包括再次手术、延迟移植物功能、原发性无功能、急性排斥反应、住院时间和移植物存活率)相似。71 名患者中有 6 名感染了 SARS-CoV-2,但均无需重症监护即可出院。COVID 期间移植结果保持相似,并且在移植期间未观察到 SARS-CoV-2 感染的严重后遗症。

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