Introduction In recent months, the number of kidney transplants from deceased donors has declined significantly. One of the reasons is the possibility of infection of the recipient with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Determining the risk of transmission of coronavirus disease 2019 (COVID-19) with a donor organ is very important for developing a kidney transplantation policy during a pandemic. Materials and method We present cases of kidney transplantation from COVID-19–positive deceased donors to 2 dialysis patients 49 and 45 years old. One of them was on hemodialysis for 28 months; the other received continuous ambulatory peritoneal dialysis (CAPD). Both patients received only basic immunosuppression, including tacrolimus, methylprednisolone, and mycophenolic acid. No antilymphocyte agents were used for induction therapy. Results Cold ischemia time was 22 and 21 hours, respectively. One recipient had delayed graft function with increasing of urine output on day 8; another had immediate function. Both patients had no febrile and no other symptoms of acute respiratory disease during their hospital stay. No abnormalities on the chest x-ray were seen. No serum anti-SARS-CoV-2 IgM and IgG were detected before and during 6 weeks after surgery. Repeated nasopharyngeal swabs real-time reverse transcription polymerase chain reaction (rRT-PCR) were negative during the period. Both recipients were discharged 5 weeks after surgery with serum creatinine levels of 122 and 91 mcmol/L, respectively. Conclusion Today we have no evidence of the possibility of transmission of COVID-19 from a SARS-CoV-2 positive donor to a kidney recipient. We also have no reason to suspect kidney damage by COVID-19 in a deceased donor at normal serum creatinine level.

We present first known case of kidney transplantation from deceased donor who was retrospectively diagnosed with COVID-19. The recipient hadn't febrile and no other symptoms of acute respiratory disease during all hospital stay. No serum anti-SARS-CoV-2 IgM, IgG were detected before and during 6 weeks after surgery. Repeated nasopharyngeal swabs rRT-PCR were negative during all the period. The patient was discharged with normal serum creatinine and doing well with no clinical or laboratory signs of COVID-19 after 6 months. The presented clinical cases demonstrate the possibility of non-transmission of SARS-Cov-2 with renal graft.

Background. Аdvantages of the retroperitoneal approach, successfully applied in some clinics, but only a few studies on direct comparison of laparoscopic and retroperitoneoscopic radical nephrectomy.The study objective: to compare transperitoneal and retroperitoneal access during laparoscopic radical nephrectomy.Materials and methods. The study included 332 patients who underwent laparoscopic radical nephrectomy for renal cell carcinoma T1a–T3b. Transperitoneal access – 134, retroperitoneal – 198.Results. The mean time of laparoscopic radical nephrectomy, as well as the time before clipping of the renal artery were significantly less in retroperitoneal access (161 ± 59 and 30 ± 24 min, respectively, compared with 178 ± 65 and 38 ± 39 min – with transperitoneal). The number of removed lymph nodes, and the number of patients detected with “positive” lymph nodes, and death from progression of disease was not significantly different between the groups transperitoneal and retroperitoneal access with an average follow-up period, 42.5 and 47.8 months respectively.Conclusion. Despite the lower popularity retroperitoneal access, the method has advantages in enhanced recovery after surgery (ERAS), particular frequency of general perioperative complications, duration of epidural anesthesia, time of normalization of bowel function and length of hospital stay compared with transperitoneal access. The method is preferred for the old age and patients with comorbidity, especially of the cardiovascular system and respiratory organs.

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