Antal Oana, Daciana Elec Alina, Muntean Adriana, Moisoiu Tudor, Melinte Razvan Marian, Elec Florin Ioan
Department of Anaesthesia and Intensive Care, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Clinical Institute of Urology and Renal Transplantation, Cluj-Napoca, Romania.
Front Med (Lausanne). 2023 Mar 23;10:1147835. doi: 10.3389/fmed.2023.1147835. eCollection 2023.
Kidney transplantation is nowadays the treatment of choice for end-stage kidney disease (ESKD), and it is the most performed organ transplantation. During the COVID-19 pandemic, kidney-transplant recipients appeared to be at higher risk of morbidity and mortality due to severe forms of illness. The result was a decrease in the number of solid organs transplants worldwide, with patients' reduced chance of receiving transplants. The best timing for surgery after COVID-19 infection is still controversial since most of the available data come from study periods with zero or low prevalence of vaccination and COVID-19 variants with high mortality rates. The American Society of Anesthesiologists (ASA) and the Anesthesia Patient Safety Foundation (APSF) Joint Statement on Elective Surgery/Procedures and Anesthesia for Patients after COVID-19 Infection states that elective surgery should be delayed for 7 weeks after a SARS-CoV-2 infection in unvaccinated patients while making no clear statement for vaccinated ones, or those which have already been infected with the virus. Kidney transplant, as opposed to tissue transplant, is not an elective surgery, so the question raised is whether to do it or not. We present the case of a hyper-immunized 47-year-old male patient with end-stage chronic kidney disease who received a second kidney transplant, despite having a mild SARS-COV 2 infection just 2 weeks before his transplantation surgery.
如今，肾移植是终末期肾病（ESKD）的首选治疗方法，也是进行得最为频繁的器官移植手术。在新冠疫情期间，肾移植受者因病情严重，似乎有更高的发病和死亡风险。结果是全球实体器官移植数量减少，患者接受移植的机会降低。新冠感染后最佳手术时机仍存在争议，因为大多数现有数据来自疫苗接种率为零或很低以及新冠病毒变异体死亡率高的研究时期。美国麻醉医师协会（ASA）和麻醉患者安全基金会（APSF）关于新冠感染患者择期手术/操作及麻醉的联合声明指出，未接种疫苗的患者在感染新冠病毒后，择期手术应推迟7周，但对于接种疫苗的患者或已感染过该病毒者未作明确说明。与组织移植不同，肾移植不是择期手术，所以引发了是否进行手术的问题。我们介绍一例47岁终末期慢性肾病的高免疫男性患者的病例，该患者在移植手术前仅两周感染了轻度新冠病毒，但仍接受了第二次肾移植。
