Practical recommendations for kidney transplantation in the COVID-19 pandemic

Ashraf Imam*, Keren Tzukert, Hadar Merhav, Riham Imam, Samir Abu-Gazala, Roy Abel, Michal Dranitzki Elhalel, Abed Khalaileh

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)223-229
Number of pages7
JournalWorld Journal of Transplantation
Volume10
Issue number9
DOIs
StatePublished - 18 Sep 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.

Keywords

  • COVID-19
  • Coronavirus
  • Kidney transplantation
  • Organ donation
  • SARSCoV2

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