Azzi Yorg, Brooks Abigail, Yaffe Hillary, Greenstein Stuart
Albert Einstein College of Medicine, Bronx, NY USA.
Montefiore-Einstein Center for Transplantation, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467-2401 USA.
Curr Transplant Rep. 2021;8(3):163-182. doi: 10.1007/s40472-021-00330-5. Epub 2021 Jun 29.
In response to the COVID-19 pandemic, vulnerable populations, such as transplant patients, were at greater risk than the regular population. In order to protect these populations, transplant centers enacted new guidelines. We approach this review by looking at how different transplant regions responded to COVID-19 and analyze the unifying themes that have proven invaluable in the subsequent waves.
We noticed that most elective surgeries including living donor transplant operations were suspended in most countries. The response to deceased donor transplants varied between countries: in some deceased donor transplants continued with modified donor and recipient criteria, while in other countries this surgery was suspended. There was a general trend of decreasing or holding antimetabolites, treating the virus with hydroxychloroquine and/or azithromycin, and converting outpatient clinics to virtual clinics.
We learned how to carefully select donors and recipients, tailor immunosuppressant regiments, and implement telemedicine. The kidney recipient population can be effectively managed in times of crisis with appropriate accommodations and measures. This review can be a model for the transplant community for future pandemics.
为应对新冠疫情，移植患者等弱势群体比普通人群面临更大风险。为保护这些人群，移植中心制定了新指南。我们通过研究不同移植地区对新冠疫情的应对方式，并分析在后续疫情浪潮中已证明非常宝贵的统一主题来进行本综述。
我们注意到，大多数国家暂停了包括活体供体移植手术在内的大多数择期手术。各国对 deceased donor 移植的应对措施各不相同：在一些国家，deceased donor 移植在修改供体和受体标准后继续进行，而在其他国家，该手术被暂停。普遍趋势是减少或停用抗代谢药物，用羟氯喹和/或阿奇霉素治疗病毒，并将门诊诊所转变为虚拟诊所。
我们学会了如何谨慎选择供体和受体、调整免疫抑制方案以及实施远程医疗。在危机时期，通过适当的调整和措施，可以有效地管理肾移植受者群体。本综述可为移植界应对未来大流行提供一个范例。
