Department of Nephrology, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.
Department of Nephrology and Kidney Transplant, Armed Forces Hospital, Taif, Saudi Arabia.
Clin Transplant. 2024 Sep;38(9):e15459. doi: 10.1111/ctr.15459.
Though virtual care was widely adopted during the COVID-19 pandemic, evidence to support its use in kidney transplant recipients early after transplantation is limited.
We conducted a retrospective cohort study comparing post kidney transplant outcomes in patients who received in-person transplant care before the COVID-19 pandemic with those who received mainly virtual transplant care during the COVID-19 pandemic. The usual-care group included 69 patients who received a kidney transplant from March 1, 2019 to September 1, 2019, and the virtual-care group included 64 patients who received a kidney transplant from September 1, 2020 to March 1, 2021.
At 6 months, five patients in the usual-care group and three patients in the virtual-care group died. There was one graft loss and one episode of acute rejection in the usual-care group, and two episodes of acute rejection in the virtual-care group (p = 0.60). Estimated glomerular filtration rate was higher for patients in the virtual-care group (59 mL/min/1.73 m vs. 52 mL/min/1.73 m, p = 0.046) and serum creatinine was not different (138 µmol/L vs. 127 µmol/L, p = 0.27). There was no difference in mean blood pressure or hospitalizations.
Outcomes were similar among recipients of a kidney transplant prior to the COVID-19 pandemic when care was mainly in person and during the pandemic when care was mainly virtual, without a signal of harm. Patient and donor selection may have led to unmeasured differences between groups.
尽管虚拟护理在 COVID-19 大流行期间得到了广泛应用,但在肾移植受者移植后早期使用虚拟护理的证据有限。
我们进行了一项回顾性队列研究,比较了 COVID-19 大流行前接受面对面移植护理的肾移植受者和 COVID-19 大流行期间主要接受虚拟移植护理的肾移植受者的移植后结局。常规护理组包括 69 名于 2019 年 3 月 1 日至 2019 年 9 月 1 日接受肾移植的患者,虚拟护理组包括 64 名于 2020 年 9 月 1 日至 2021 年 3 月 1 日接受肾移植的患者。
在 6 个月时,常规护理组有 5 名患者死亡,虚拟护理组有 3 名患者死亡。常规护理组发生 1 例移植物丢失和 1 例急性排斥反应,虚拟护理组发生 2 例急性排斥反应(p = 0.60)。虚拟护理组患者的估计肾小球滤过率较高(59 mL/min/1.73 m 2 比 52 mL/min/1.73 m 2 ,p = 0.046),而血清肌酐无差异(138 µmol/L 比 127 µmol/L ,p = 0.27)。两组患者的平均血压或住院率无差异。
在 COVID-19 大流行前主要采用面对面护理的肾移植受者和在大流行期间主要采用虚拟护理的肾移植受者中,结局相似,没有危害的信号。患者和供体的选择可能导致组间存在无法衡量的差异。