TY - JOUR
T1 - Practical recommendations for kidney transplantation in the COVID-19 pandemic
AU - Imam, Ashraf
AU - Tzukert, Keren
AU - Merhav, Hadar
AU - Imam, Riham
AU - Abu-Gazala, Samir
AU - Abel, Roy
AU - Elhalel, Michal Dranitzki
AU - Khalaileh, Abed
N1 - Publisher Copyright:
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
PY - 2020/9/18
Y1 - 2020/9/18
N2 - Kidney transplantation at the time of a global viral pandemic has become challenging in many aspects. Firstly, we must reassess deceased donor safety (for the recipient) especially in communities with a relatively high incidence of coronavirus disease 19 (COVID-19). With respect to elective live donors, if one decides to do them at all, similar considerations must be made that may impose undue hardship on the donor. Recipient selection is also problematic since there is clear evidence of a much higher morbidity and mortality from COVID-19 for patients older than 60 and those with comorbidities such as hypertension, diabetes, obesity and lung disease. Unfortunately, many, if not most of dialysis patients fit that mold. We may and indeed must reassess our allocation policies, but this must be done based on data rather than conjecture. Follow-up routines must be re-engineered to minimize patient travel and exposure. Reliance on technology and telemedicine is paramount. Making this technology available to patients is extremely important. Modifying or changing immunosuppression protocols is controversial and not based on clinical studies. Nevertheless, we should reassess the need for induction therapy across the board for ordinary patients and the more liberal use of mammalian target of rapamycin inhibitors in transplant patients with proven infection.
AB - Kidney transplantation at the time of a global viral pandemic has become challenging in many aspects. Firstly, we must reassess deceased donor safety (for the recipient) especially in communities with a relatively high incidence of coronavirus disease 19 (COVID-19). With respect to elective live donors, if one decides to do them at all, similar considerations must be made that may impose undue hardship on the donor. Recipient selection is also problematic since there is clear evidence of a much higher morbidity and mortality from COVID-19 for patients older than 60 and those with comorbidities such as hypertension, diabetes, obesity and lung disease. Unfortunately, many, if not most of dialysis patients fit that mold. We may and indeed must reassess our allocation policies, but this must be done based on data rather than conjecture. Follow-up routines must be re-engineered to minimize patient travel and exposure. Reliance on technology and telemedicine is paramount. Making this technology available to patients is extremely important. Modifying or changing immunosuppression protocols is controversial and not based on clinical studies. Nevertheless, we should reassess the need for induction therapy across the board for ordinary patients and the more liberal use of mammalian target of rapamycin inhibitors in transplant patients with proven infection.
KW - COVID-19
KW - Coronavirus
KW - Kidney transplantation
KW - Organ donation
KW - SARSCoV2
UR - http://www.scopus.com/inward/record.url?scp=85102305867&partnerID=8YFLogxK
U2 - 10.5500/wjt.v10.i9.223
DO - 10.5500/wjt.v10.i9.223
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AN - SCOPUS:85102305867
SN - 2220-3230
VL - 10
SP - 223
EP - 229
JO - World Journal of Transplantation
JF - World Journal of Transplantation
IS - 9
ER -