Clin Nephrol. 2022 Jul;98(1):54-61. doi: 10.5414/CN110847.
Transplanting kidneys from donors with a recent history of severe SARS-CoV-2 pneumonia is uncommon due to concerns about the risk of viral transmission and the quality of kidneys from these donors. To date, there are no conclusive data on viral transmission from extrapulmonary solid organ transplants. Given the prevalence of SARS-CoV-2 infections in potential donors, shortage of kidneys available for transplantation, and low risk of viral transmission, we developed a clinical protocol for accepting kidneys from donors with recent severe SARS-CoV-2 pneumonia who demonstrate preserved kidney function.
We collected data on early outcomes of 5 kidney transplant recipients from 4 deceased donors hospitalized for severe SARS-CoV-2 infection.
Donor creatinine ranged from 0.51 to 0.60 mg/dL and kidney donor profile index (KDPI) from 14 to 52%. Three of the five kidneys were from donation after circulatory death. All recipients were fully vaccinated, and 4/5 received post-exposure prophylactic monoclonal antibody treatment. While 3 recipients had delayed graft function, all had excellent graft function at 3 or 4 weeks post-operatively. None of the recipients displayed signs or symptoms of SARS-CoV-2 infection post-transplant.
Our findings suggest that kidney grafts from donors with a recent history of severe SARS-CoV-2 infection but with preserved kidney function can be safely used and have good early outcomes.
由于担心病毒传播风险和这些供体肾脏的质量，近期有严重 SARS-CoV-2 肺炎史的供体肾脏移植并不常见。迄今为止，尚无关于肺外实体器官移植中病毒传播的明确数据。鉴于潜在供体中 SARS-CoV-2 感染的流行、可用于移植的肾脏短缺以及低病毒传播风险，我们制定了一项从近期患有严重 SARS-CoV-2 肺炎但肾功能正常的供体接受肾脏的临床方案。
我们收集了 4 名因严重 SARS-CoV-2 感染住院的已故供体的 5 名肾移植受者的早期结局数据。
供体肌酐值为 0.51 至 0.60mg/dL，肾供体状况指数（KDPI）为 14 至 52%。5 个肾脏中有 3 个来自循环死亡后捐献。所有受者均已完全接种疫苗，且 4/5 例接受了暴露后预防性单克隆抗体治疗。尽管 3 例受者出现了延迟移植物功能，但所有受者在术后 3 或 4 周时均具有良好的移植物功能。移植后受者均无 SARS-CoV-2 感染的迹象或症状。
我们的发现表明，近期有严重 SARS-CoV-2 感染史但肾功能正常的供体的肾脏移植物可以安全使用，并具有良好的早期结局。
