Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
J Infect Chemother. 2021 Jul;27(7):1097-1101. doi: 10.1016/j.jiac.2021.03.018. Epub 2021 Mar 29.
A 49-year-old Asian male, who had undergone hemodialysis for >16 years, complained of a fever, dysgeusia and dysosmia, and was diagnosed with COVID-19 pneumonia based on severe acute respiratory syndrome coronavirus 2 polymerase chain reaction (SARS-CoV-2 PCR) and computed tomography (CT). Treatment was started with oral favipiravir and ciclesonide inhalation. On the 10th day of treatment, the patient had a persistent high fever and a chest CT showed exacerbation of pneumonia, so dexamethasone was intravenously started. He was discharged after confirming two consecutive negative SARS-CoV-2 PCR tests. Three months after COVID-19 treatment, a SARS-CoV-2 PCR test was negative and he underwent a deceased donor kidney transplantation. Basiliximab induction with triple drug immunosuppression consisting of extended-release tacrolimus, mycophenolate mofetil and prednisolone, which is our regular immunosuppression protocol, was used. He was discharged on postoperative day 18 without the need for postoperative hemodialysis or any complications. The serum creatinine level was 1.72 mg/dL 95 days postoperatively and he had a favorable clinical course that was similar to deceased donor kidney recipients without a history of SARS-CoV-2 infection.
We report the first case of a kidney transplantation after COVID-19 treatment in Japan and the fourth case globally. We would like to provide information about our successful case due to the anticipated increase in similar candidates in the near future.
一位 49 岁的亚裔男性，因终末期肾病已接受血液透析治疗>16 年，出现发热、味觉和嗅觉异常，并根据严重急性呼吸综合征冠状病毒 2 聚合酶链反应（SARS-CoV-2 PCR）和计算机断层扫描（CT）诊断为 COVID-19 肺炎。治疗开始给予口服法维拉韦和环索奈德吸入。治疗第 10 天，患者持续高热，胸部 CT 显示肺炎加重，因此开始静脉注射地塞米松。两次连续 SARS-CoV-2 PCR 检测阴性后出院。COVID-19 治疗后 3 个月，SARS-CoV-2 PCR 检测阴性，患者接受了已故供体肾移植。根据我们的常规免疫抑制方案，使用巴利昔单抗诱导三联药物免疫抑制，包括延长释放他克莫司、霉酚酸酯和泼尼松龙。术后第 18 天患者出院，无需术后血液透析或任何并发症。术后 95 天血清肌酐水平为 1.72mg/dL，患者的临床过程良好，与无 SARS-CoV-2 感染史的已故供体肾受者相似。
我们报告了日本首例 COVID-19 治疗后肾移植病例，也是全球第 4 例。由于预计在不久的将来会有更多类似的候选者，我们希望提供我们成功病例的信息。
