Department of General Surgery and Transplantology, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland; Center of Postgraduate Medical Education, Department of General Surgery and Transplantology, Warsaw, Poland.
University of Warmia and Mazury in Olsztyn, Olsztyn, Poland.
Transplant Proc. 2022 May;54(4):917-924. doi: 10.1016/j.transproceed.2022.02.043. Epub 2022 Mar 16.
Solid graft recipients are at an increased risk of serious complications and death. Out of 130 outpatient recipients of pancreas grafts at our Clinic, 20 patients (15.73%) had a confirmed severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2). Each patient had a different course of the disease, and the forms of infection varied from mild to severe and lethal. According to recommendations, after confirmation of the infection, mycophenolate mofetil was withdrawn and the immunosuppression was based on steroids and a calcineurin inhibitor. In this study, we performed an analysis of the course of COVID-19 infection in patients after pancreatic transplantation. Twenty pancreas recipients were confirmed to have COVID-19 infections; 4 of whom required hospitalization owing to severe complications. Patients reported weakness, excessive intensity of fatigue, shortness of breath with exertion, cough, and periodically increased temperature. Weakness and fatigue persisted in these patients for about 6 weeks. In 2 patients there was a need for oxygen supplementation and empirical antibiotic. Mortality was 5%, and there was 1 graftectomy. Deterioration of either kidney or pancreas graft were not observed in any other patients. The course of SARS-CoV-2 infection in solid graft recipients is similar to that of the rest of the population. Because of immunosuppression, recipients were accustomed to avoiding crowds and complying with obligations to wear masks.
实体器官移植受者发生严重并发症和死亡的风险增加。在我们诊所的 130 名门诊胰腺移植受者中，有 20 名（15.73%）被确诊患有严重急性呼吸综合征冠状病毒 2 感染（SARS-CoV-2）。每位患者的疾病进程不同，感染形式从轻症到重症乃至致死性不等。根据建议，在确认感染后，停用霉酚酸酯，免疫抑制基于类固醇和钙调神经磷酸酶抑制剂。在这项研究中，我们对胰腺移植后 COVID-19 感染患者的病程进行了分析。20 名胰腺受者被确诊患有 COVID-19 感染；其中 4 名因严重并发症需要住院治疗。患者报告有乏力、过度疲劳、用力时呼吸急促、咳嗽和定期体温升高。这些患者的乏力和疲劳持续了约 6 周。其中 2 例需要氧疗和经验性抗生素治疗。死亡率为 5%，有 1 例进行了胰切除术。在其他患者中，没有观察到肾脏或胰腺移植物恶化的情况。实体器官移植受者的 SARS-CoV-2 感染病程与其他人群相似。由于免疫抑制，受者习惯于避免人群并遵守戴口罩的义务。
