Session Name: COVID-19
Session Date & Time: None. Available on demand.
*Purpose: Study short term outcomes of living kidney donors (LKD) who were previously infected with COVID 19, and in their recipients.
*Methods: After a brief hiatus due to COVID March-May 2020, 33 living donor transplants have been performed at our center so far. Of these, we identified 3 consecutive LKD who were diagnosed with COVID prior to transplant. We collected retrospective data on clinical characteristics for these donors, and recipients of these previously infected donors. They were approved after meeting institutional requirements of resolution of COVID. Donors and recipients were required to have a negative Nasopharyngeal testing by NAT for SARS-CoV-2, 28 days post symptom resolution, and a repeat negative test 48 hours prior to transplant.
*Results: Table 1 shows demographics, severity of COVID, timing of donation and post-donation course of the 3 LKD .
Mean time to donation from COVID diagnosis was 56 days. All had mild disease with no hospitalization. None had hematuria or proteinuria prior to donation. Post donation course was uncomplicated in all, with expected initial decline in GFR. In one (D#2), post-perfusion biopsy showed an incidental finding of IgA nephropathy (Oxford Classification 0). There were no viral particles on electron microscopy. There was patchy podocyte foot process effacement, believed to be from recurrence of FSGS in recipient(R#2). Clinical characteristics and post-transplant course of recipients of these LKD are shown in
One patient (R#1), previously had COVID. Post-transplant course was uneventful in 2 recipients. One (R#2) developed recurrence of FSGS immediately post-transplant. Her course was further complicated by COVID on post-op day 7, moderate in severity, managed by reduction in immunosuppression, bamlanivimab, steroids & remdesivir. While the exact exposure for this patient is yet to be determined, she appears to have contracted it from the community.
*Conclusions: LKD with previously resolved COVID appear to have an uncomplicated immediate post-donation course. Recipients of LKD with resolved COVID tend to do well. Questions remain regarding optimal timing of donation and transplant after COVID resolution, to minimize risk of SARS-CoV2 transmission through tissue, even with negative nasopharyngeal PCR
To cite this abstract in AMA style:Prashar R, Khoury NJ, Ramesh M, Patel AK. Short Term Outcomes in Previously Covid Positive Living Kidney Donors and Their Recipients [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/short-term-outcomes-in-previously-covid-positive-living-kidney-donors-and-their-recipients/. Accessed September 24, 2021.
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