Criteria and Practice Patterns for Accepting Living Donors with Prior Covid-19: A National Survey

A. Jawed¹, M. Y. Jan², N. Barros², O. Adebiyi², A. Diez³, J. Fridell², W. Goggins², M. Yaqub², M. A. Mujtaba⁴, T. Taber², V. Kumar⁵, K. Lentine⁶, A. Sharfuddin²

¹Wayne State University, Detroit, IN, ²Indiana University School of Medicine, Indianapolis, IN, ³The Ohio State University, Columbus, OH, ⁴UTMB Galveston, Galveston, TX, ⁵University of Alabama, Birmingham, AL, ⁶St. Louis University, St. Louis, MO

Meeting: 2021 American Transplant Congress

Abstract number: 997

Keywords: Donation, Infection, Living donor

Topic: Clinical Science » Kidney » Kidney Living Donor: Selection

Session Information

Session Name: Kidney Living Donor: Selection

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: A critical question facing transplant programs is if, when and how to safely accept living kidney donors (LKD) who have a history and recovered from COVID-19 Infection. The purpose of the study is to understand current practices related to accepting living donors for donation who have recovered from COVID-19.

*Methods: We surveyed US transplant programs from September 3, 2020 through November 3, 2020 by e-mail and postings to professional society list-serves. Center level as well individual opinion based responses were analyzed.

*Results: A total of 174 US respondents from 115 unique centers responded, representing 59% of US Living Donor Programs and 72.4% of 2019 and 71.9% of 2020 LKD volume (as of October 31, 2020). Respondent Roles included Nephrologist (53.4%); Surgeon (19.5%); Infectious Disease (11.5%); Coordinator (9.8%).

Overall during the survey period, 48.6% of responding centers had received inquiries from such LKDs, while 44.3% were currently evaluating such donors. A total of 98 donors were reported to be in the evaluation phase, while 27.8% centers had approved a total of 42 such donors to proceed with donation.

*Conclusions: Selection practices and criteria for LKD who have recovered from COVID-19 are variable. Ongoing research and consensus building are needed to guide optimal practices to ensure the safety of accepting such donors.

Responses for Questions Related to Donor Evaluation Who Have Recovered from COVID-19
Accepting LKD who have recovered from COVID-19?	Yes (53.4%), Case-by Case (38%); Decline/Unsure (6.3%)
Accept LKD with past COVID-19 for Non-Directed Donation	Yes (62%); Unsure (28%); No (7.5%)
Accept LKD with past COVID-19 for KPD.	Yes (68.4%); Unsure (22.4%); No (7.5%)
Accept LKD with past COVID-19 for High Immunological Risk Recipient	Yes (63.8%); Unsure (26.4%); No (8.0%)
Minimum Time From Onset of Infection To Evaluation	>3mo (39.1%); >2mo (13.2%); >1mo (34.5%)
Minimum Time from Onset of infection to Donation Surgery	>3mo (48.9%); >2mo (11.5%); >1mo (27%)
Consider Additional testing ?	Chest CT (65%); PFT (51%)
Any other COVID-19-Specific testing During Evaluation ?	IGM (29.3%); IGG (52.3%); Antigen (16.1%)

Responses for Questions Related to Recipients who Receive COVID-19 recovered LD Kidneys
Modify Immunosuppression protocol ?	NO (64%); Case-by-Case (14%); Unsure (15.5%)
Screen Recipient for COVID-19 Post-Transplant ?	No (51.7%); Yes 42.5%)
If screening, time frame to Screen ?	<1mo (71%); >1mo (20.5%); >2mo (1.4%); >3mo (1.4%)
If Screening, Type of Test ?	NP-PCR (35.6%); IGM (12%); IGG (12.6%); Antigen (10%)

To cite this abstract in AMA style:

Jawed A, Jan MY, Barros N, Adebiyi O, Diez A, Fridell J, Goggins W, Yaqub M, Mujtaba MA, Taber T, Kumar V, Lentine K, Sharfuddin A. Criteria and Practice Patterns for Accepting Living Donors with Prior Covid-19: A National Survey [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/criteria-and-practice-patterns-for-accepting-living-donors-with-prior-covid-19-a-national-survey/. Accessed November 21, 2024.

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