*Purpose: The emergence of SARS-CoV-2 and the clinical syndrome of COVID-19 have significantly disrupted routine healthcare and life-saving procedures, including solid organ transplantation. This resulted in holding living donor program activity and limiting solid organ transplant at many transplant centers. We examined the trend of kidney transplant volume before and after the first peak of COVID-19 to quantity the impact of the pandemic on kidney transplant practices.

*Methods: Data on kidney transplant procedures from the national organ registries, Organ Procurement and Transplantation Network, 1/1/2019-5/31/2020) and Scientific Registry of Transplant Recipients (6/1/2020-9/30/2020) were examined. We excluded multiple organ transplantation.

*Results: There were 12,757 deceased donor and 1,889 living donor kidney transplants between Jan 2020 and Sep 2020. The volume plummeted in March, reached a nadir in April, and gradually increased starting from May. There were only 72 living donor kidney transplants performed in April 2020, compared to 530 in the April 2019. However, by September 2020, the volume appeared to return to a level similar to the same month in 2019. In a similar pattern, numbers of kidneys recovered for transplantation decreased in March and April, before recovering in May 2020. Figure 1

*Conclusions: As testing and PPE supply improve along with more experience with conducting safe transplant procedures during the pandemic, recommendations regarding transplant practice during COVID-19 continue to evolve. The availability of COVID-19 testing with rapid PCR results before transplant has led to an uptake of solid organ transplants and a recovery of suspended practice. Ongoing monitoring of both practices and outcomes is necessary to guide decisions of proceeding with transplantation as the country faces additional surges of COVID-19 during the winter months.

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