COVID-19 in Kidney Transplantation

A special issue of Transplantology (ISSN 2673-3943). This special issue belongs to the section "Solid Organ Transplantation".

Deadline for manuscript submissions: closed (20 August 2022) | Viewed by 12750

Special Issue Editors


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Guest Editor
Department of Transplantation—Renal Unit, Careggi University Hospital, 50139 Florence, Italy
Interests: immunology; renal transplantation; epidemiology; coronavirus infection; organ transplantation
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Division of Nephrology, Santa Maria Annunziata Hospital, Florence, Italy
Interests: renal transplantation; clinical nephrology; renal pathology

Special Issue Information

Dear Colleagues,

Kidney transplant recipients may be at a uniquely increased risk of serious complications from COVID-19 compared to the general population because of their chronically immunosuppressed state. This Special Issue will describe the epidemiology of COVID-19 in kidney transplant recipients. Manifestations, appropriate management, and clinical outcomes based on the available literature. In addition, we should consider the impact of COVID-19 on kidney transplant activity and transplant volume.

Prof. Dr. Maurizio Salvadori
Dr. Aris Tsalouchos
Guest Editors

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Keywords

  • Epidemiology
  • Transplant activity
  • Renal pathology
  • Clinical outcomes
  • Appropriate treatment

Published Papers (5 papers)

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Editorial

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3 pages, 175 KiB  
Editorial
COVID-19 and Kidney Transplantation
by Maurizio Salvadori and Aris Tsalouchos
Transplantology 2021, 2(3), 288-290; https://0-doi-org.brum.beds.ac.uk/10.3390/transplantology2030027 - 26 Jul 2021
Viewed by 2075
Abstract
The morbidity and mortality from COVID-19 are particularly high among patients with underlying health disease conditions and chronic disease, among which are kidney transplant recipients (KTRs) [...] Full article
(This article belongs to the Special Issue COVID-19 in Kidney Transplantation)

Review

Jump to: Editorial

19 pages, 1489 KiB  
Review
What Is New in Prophylaxis and Treatment of COVID-19 in Renal Transplant Patients? A Report from an ESOT Meeting on the Topic
by Maurizio Salvadori
Transplantology 2022, 3(4), 288-306; https://0-doi-org.brum.beds.ac.uk/10.3390/transplantology3040030 - 02 Nov 2022
Viewed by 1846
Abstract
I should highlight that this manuscript is not a formal review on the topic, but a report from an ESOT meeting held on 22 June 2022. The assumption of immunosuppressants exposes kidney transplant recipients to the risk of infections, including COVID-19 infection. A [...] Read more.
I should highlight that this manuscript is not a formal review on the topic, but a report from an ESOT meeting held on 22 June 2022. The assumption of immunosuppressants exposes kidney transplant recipients to the risk of infections, including COVID-19 infection. A transplant patient having COVID-19 infection raises several questions, including whether the immunosuppressive therapy should be reduced with the consequent risk of favoring acute rejections. Patient vaccination before transplantation is probably the gold standard to avoid the risk of COVID-19 infection after transplantation. In the case of transplant patients, three measures may be undertaken: vaccination, use of monoclonal antibodies and use of therapeutic antiviral small molecules. Concerning vaccination, it is still debated which one is the best and how many doses should be administered, particularly considering the new variants of the virus. The onset of virus variants has stimulated researchers to find new active vaccines. In addition, not all transplant patients develop antibodies. An alternative prophylactic measure to be principally used for patients that do not develop antibodies after vaccination is the use of monoclonal antibodies. These drugs may be administered as prophylaxis or in the early stage of the disease. Finally, the small antiviral molecules may be used again as prophylaxis or treatment. Their major drawbacks are their interference with immunosuppressive drugs and the fact that some of them cannot be administered to patients with low eGFR. Full article
(This article belongs to the Special Issue COVID-19 in Kidney Transplantation)
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11 pages, 303 KiB  
Review
COVID-19 and Kidney Transplantation: Epidemiology, Histopathological Presentation, Clinical Presentation and Outcomes, and Therapeutic Strategies
by Maurizio Salvadori and Aris Tsalouchos
Transplantology 2022, 3(3), 219-229; https://0-doi-org.brum.beds.ac.uk/10.3390/transplantology3030023 - 30 Jun 2022
Viewed by 1826
Abstract
Multiple case series of kidney transplant recipients with COVID-19 have shown increased mortality compared to nontransplant patients. To date, we do not have high-level evidence to inform immunosuppression minimization strategies in infected transplant recipients. Most centers, however, have adopted an early antimetabolite withdrawal [...] Read more.
Multiple case series of kidney transplant recipients with COVID-19 have shown increased mortality compared to nontransplant patients. To date, we do not have high-level evidence to inform immunosuppression minimization strategies in infected transplant recipients. Most centers, however, have adopted an early antimetabolite withdrawal in addition to other interventions. The epidemiological problem concerns also dialysis patients and waitlisted patients who have a higher COVID-19 infection diffusion with respect to kidney transplant recipients. Several factors influence mortality among kidney transplant recipients. Among these factors are the age, race, and comorbidity factors, such as hypertension, diabetes mellitus, obesity, and previous respiratory problems. Treatment is still limited. The only effective antiviral drug is remdesivir that should be administered before the development of the cytokine storm. Vaccination seems to be useful, but due to the concomitant immunosuppression limiting its efficacy, at least three or four doses should be administered. Full article
(This article belongs to the Special Issue COVID-19 in Kidney Transplantation)
16 pages, 1686 KiB  
Review
SARS-CoV-2 in Kidney Transplant Recipients: A Systematic Review
by Naveen Kumar, Rashmi Rana, Devinder Singh Rana, Anurag Gupta and Mohinder Pal Sachdeva
Transplantology 2022, 3(1), 33-48; https://0-doi-org.brum.beds.ac.uk/10.3390/transplantology3010004 - 20 Jan 2022
Cited by 3 | Viewed by 3355
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global healthcare crisis. Kidney transplant (KTx) patients and the patients with chronic kidney disease are two of the most vulnerable populations to the risks of coronavirus disease 2019 (COVID-19). A systematic literature search [...] Read more.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global healthcare crisis. Kidney transplant (KTx) patients and the patients with chronic kidney disease are two of the most vulnerable populations to the risks of coronavirus disease 2019 (COVID-19). A systematic literature search on PubMed and Web of Science was conducted. We analyzed published case reports, case series and articles on COVID-19’s clinical presentation, management, outcomes and vaccination among kidney transplant recipients. A total of 33 studies were included in the study, which included 1676 KTx recipients and 108 waiting list patients infected with COVID-19. These studies reported the clinical presentation, management and immunosuppressive adjustment among the KTx recipients. The remaining studies focused on other aspects, such as vaccination and transplantation, during the COVID-19 pandemic. Mortality due to COVID-19 was observed to be the highest for KTx recipients, followed by patients on hemodialysis, and lowest in the general population. There is no definitive treatment of COVID-19 yet, and managing transplant patients is enigmatic of this: the treatment is based on symptom management. There is an urgent need for guidelines on managing kidney transplant recipients and immunosuppressive adjustments for the course of COVID-19 treatment. Full article
(This article belongs to the Special Issue COVID-19 in Kidney Transplantation)
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8 pages, 215 KiB  
Review
Kidney Transplantation during the SARS-CoV-2 Pandemic in Israel: Experience from a Large-Volume Center
by Aviad Gravetz, Vladimir Tennak, Vadym Mezhebovsky, Michael Gurevich, Sigal Eisner and Eviatar Nesher
Transplantology 2021, 2(4), 433-440; https://0-doi-org.brum.beds.ac.uk/10.3390/transplantology2040041 - 19 Oct 2021
Cited by 1 | Viewed by 2286
Abstract
Coronavirus disease 2019 (COVID-19) has affected tens of millions of people globally since it was declared a pandemic by the World Health Organization on 11 March 2020. Since its outbreak in December 2019, the ongoing coronavirus COVID-19 pandemic has led to global social, [...] Read more.
Coronavirus disease 2019 (COVID-19) has affected tens of millions of people globally since it was declared a pandemic by the World Health Organization on 11 March 2020. Since its outbreak in December 2019, the ongoing coronavirus COVID-19 pandemic has led to global social, economic and healthcare crises affecting millions of people and causing the death of hundreds of thousands of people worldwide. As with other fields of healthcare, the pandemic with its heavy workload imposed on hospital services and personnel significantly affected solid organ transplantation. Concerns for potential exposure to the virus and its related severe acute respiratory syndrome coronavirus type 2 (SARS-CoV2) have profoundly altered the process of organ donation and recovery, acceptance of organ offers, management of potential recipients and living donors, and above all transplanted and immunosuppressed patients. All those issues required prompt implementation of new practice measures and guidelines as well as continuous adaptations to the fluid and rapidly changing situation. Herein we describe a single transplant center experience with kidney transplantation during the COVID-19 pandemic; we review the national and institutional measures and restrictions undertaken in different phases of the ongoing event as well as the outcomes. Full article
(This article belongs to the Special Issue COVID-19 in Kidney Transplantation)
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