Urology and Nephrology Research Center (UNRC), Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
Department of Urology, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Urol J. 2022 Feb 8;19(2):126-130. doi: 10.22037/uj.v18i.6930.
To present the early to midterm experience of two referral kidney transplantation centers with living and deceased kidney transplantations that were performed within the COVID-19 pandemic.
All cases performed in two referral centers in Iran within the COVID-19 pandemic were investigated. Transplantations were performed from May 2020 to February 2021. The protocol for screening included nasopharyngeal RT-PCR with chest CT scan for living and deceased transplantations in center A and RTPCR for living transplantations and chest CT scan for deceased transplantations in center B. Patients were followed for 14-26 months after transplantation regarding COVID-19 infection and its outcomes in case of infection.
103 kidney transplantations were performed during the study period including 54 (52.4%) living and 49 (47.6%) deceased kidney transplantations. Twenty-four recipients (23.3%) and a living donor (1%) were infected with COVID-19. The severity of COVID-19 infection was mild, moderate, severe, and critical in 16 (66.6%), 4 (16.6%), 2 (8.4%), and 2 patients (8.4%), respectively. Two mortalities were observed within transplantation recipients with COVID-19 infection (1.9%). 87.5% (7/8) COVID-19 infections in center B were observed in recipients of deceased transplantations who were screened only by chest CT scan.
The results of this study indicate a low frequency of COVID-19 mortality (1.9% for the whole cohort and 8.3% within COVID-19 infected patients) for recipients of living and deceased kidney transplantation that were performed within the COVID-19 pandemic. The above findings highlight for the first time in a large study the probability of living kidney transplantation during the COVID-19 pandemic in case strict screening of donors and recipients and close supervision of operating rooms and wards are implemented. We further hypothesize the inadequacy of chest CT scan for screening of COVID-19 in kidney transplantation surgery candidates.
介绍两家转诊肾移植中心在 COVID-19 大流行期间进行活体和已故肾移植的早期至中期经验。
调查了伊朗两家转诊中心在 COVID-19 大流行期间进行的所有病例。移植手术于 2020 年 5 月至 2021 年 2 月进行。筛选方案包括中心 A 的鼻咽 RT-PCR 和胸部 CT 扫描用于活体和已故移植，以及中心 B 的活体移植的 RTPCR 和已故移植的胸部 CT 扫描。在移植后 14-26 个月对 COVID-19 感染及其感染后果对患者进行随访。
在研究期间进行了 103 例肾移植，其中 54 例（52.4%）为活体和 49 例（47.6%）为已故肾移植。24 名受者（23.3%）和 1 名活体供者（1%）感染了 COVID-19。16 例（66.6%）、4 例（16.6%）、2 例（8.4%）和 2 例（8.4%）患者的 COVID-19 感染严重程度分别为轻度、中度、重度和危重度。在接受 COVID-19 感染的移植受者中观察到 2 例死亡（1.9%）。在仅接受胸部 CT 扫描筛查的已故移植受者中，中心 B 观察到 87.5%（7/8）的 COVID-19 感染。
本研究结果表明，在 COVID-19 大流行期间进行活体和已故肾移植的受者 COVID-19 死亡率较低（全队列为 1.9%，COVID-19 感染患者为 8.3%）。上述发现首次强调，在严格筛选供者和受者并密切监测手术室和病房的情况下，COVID-19 大流行期间有可能进行活体肾移植。我们进一步假设胸部 CT 扫描不适用于肾移植手术候选者的 COVID-19 筛查。
