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- Page navigation anchor for RE: Organ Transplants drop dramatically during pandemicRE: Organ Transplants drop dramatically during pandemic
Many transplant centers have temporarily shut down their living donor kidney transplant programs “to ease pressure on hospitals and protect donors and recipients from COVID-19” 1. These actions make sense given the current pandemic. At the same time, pre-emptive renal transplantation with a living donor remains the optimal therapy for endstage renal disease 2. Without this being an available therapeutic option, patients are being exposed to more dialysis and its associated risks (including increased risk of COVID-19). For example, based on registry data from France, the COVID-19 mortality rate was 30% among waitlisted hemodialysis patients compared to 13% in the kidney transplant population 3. As of may 6, 2020, the ERA-EDTA COVID-19 database has reported mortality rates of 20% and 18% for dialysis and kidney transplant patients, respectively 4.
With this data in mind, workup of living donors must continue. Yet, strategies that minimize visits to hospital, address donor COVID-19-related anxiety and provide proper follow up are essential. How can this be achieved?
First, in-person donor evaluations will be necessary in dedicated “cold zones” of the hospital. Testing must also be condensed (if possible) into a period of 1-2 days so that repeated trips to the hospital can be minimized. Furthermore, the peri-operative period is generally a stressful time for the living donor. In the era of SARS-Cov-2, this anxiety is likely to be increased. Mandatory SARS-CoV-2...
Show MoreCompeting Interests: None declared.References
- 1. Brian Owens. Organ transplants drop dramatically during pandemic. CMAJ 2020;192:E692-E693.
- 2. Yoo, S.W., Kwon, O.J. & Kang, C.M. Preemptive living-donor renal transplantation: outcome and clinical advantages. Transplant Proc 41, 117-120 (2009).
- 3. Reprise de l’activité de greffe rénale adulte en période épidémique de SARS-CoV-2 (Covid-19). Recommandation des sociétés savantes (SFT/SFNDT/AFU).www.transplantation-francophone.org/covid-19. Published 7-5-2020. Accessed 14-5-2020
- 4. The ERA-EDTA Covid-19 database for patients on kidney replacement therapy.www.era-edta.org. Published 6-5-2020. Accessed 20-5-2020.
- 5. Segev DL. Innovative Strategies in living donor kidney transplantation. Nature Reviews Nephrology. 8, 332-8 (2012)