Clinical Practice Guideline for Solid Organ Donation and Transplantation During the COVID-19 Pandemic

Abstract

Background. The coronavirus 2019 (COVID-19) pandemic has disrupted health systems worldwide, including solid organ donation and transplantation programs. Guidance on how best to screen patients who are potential organ donors to minimize the risks of COVID-19 as well as how best to manage immunosuppression and reduce the risk of COVID-19 and manage infection in solid organ transplant recipients (SOTr) is needed. Methods. Iterative literature searches were conducted, the last being January 2021, by a team of 3 information specialists. Stakeholders representing key groups undertook the systematic reviews and generation of recommendations using a rapid response approach that respected the Appraisal of Guidelines for Research and Evaluation II and Grading of Recommendations, Assessment, Development and Evaluations frameworks. Results. The systematic reviews addressed multiple questions of interest. In this guidance document, we make 4 strong recommendations, 7 weak recommendations, 3 good practice statements, and 3 statements of "no recommendation." Conclusions. SOTr and patients on the waitlist are populations of interest in the COVID-19 pandemic. Currently, there is a paucity of high-quality evidence to guide decisions around deceased donation assessments and the management of SOTr and waitlist patients. Inclusion of these populations in clinical trials of therapeutic interventions, including vaccine candidates, is essential to guide best practices.

Low acceptance rate of COVID‐19 vaccination and reduced quality of life among heart transplant recipients during the COVID‐19 pandemic

“…There is sufficient evidence to confirm the effectiveness and safety of COVID-19 vaccines in HRTs. [32][33][34][35][36] However, in our cohort, only 12 patients (13.6%) received COVID-19 vaccination. We found that the QoL of HTRs has significantly decreased since the COVID-19 outbreak compared to that in 2019.…”

Kidney Transplantation in Times of Covid-19: Decision Analysis in the Canadian Context

“…Based on published literature, COVID-19 was assumed to have no significant impact on graft failure. 54 As ESKD patients are considered a population at risk, we assumed that they were offered vaccination as a priority group with 2 doses administered within 3 months. In the vaccination scenario, community infection rates were assumed to decrease to null in a linear fashion over a period of 6 months after the beginning of the vaccination campaign.…”

Langfristige körperliche und psychische Folgen chronischer Nierenerkrankungen

“…Während der COVID-19-Pandemie ist die Zahl der Nierentransplantationen weltweit deutlich zurückgegangen [ 77 , 78 ]. Die Behandlung von bereits transplantierten Patient:innen unter immunsuppressiver Medikation, die an COVID-19 erkranken, ist schwierig – sowohl im Hinblick auf die Modifikation der immunsuppressiven Therapie zum Erhalt der Transplantatfunktion wie auch im Hinblick auf die optimale Therapie von COVID-19 [ 77 , 79 – 81 ].…”