COVID-19 and kidney transplantation: an Italian Survey and Consensus

Vistoli, Fabio; Furian, Lucrezia; Maggiore, Umberto; Caldara, Rossana; Cantaluppi, Vincenzo; Ferraresso, Mariano; Zaza, Gianluigi; Cardillo, Massimo; Biancofiore, Gianni; Menichetti, Francesco; Russo, Alessandro; Turillazzi, Emanuela; Paolo, Marco Di; Grandaliano, Giuseppe; Boggi, Ugo; Brunori, Giuliano; Petrini, Flavia; Valenza, Franco; Lavezzo, Bruna; Bonucchi, Decenzio; Capocasale, E.; Grossi, Paolo; Ponticelli, Claudio; Sandrini, Silvio; Schena, Francesco Paolo; Segoloni, Giuseppe; Biancone, Luigi; Boschiero, Luigino; Rigotti, Paolo; Comai, Giorgia; Bossini, Nicola; Minetti, Enrico; Iaria, Giuseppe; Ambrosini, A; Messa, P.; Boscutti, Giuliano; Carmellini, Mario; Caputo, Flavia; Ranghino, Andrea; Rosa, Paride De; Federico, Stefano; Veroux, Massimiliano; Cirami, Calogero; Nordio, Maurizio; Citterio, Franco; Piredda, Gian Benedetto; Pretagostini, R.; Paolis, Paolo De; Rampino, Teresa; Pisani, Francesco; Cappelli, Gianni; Secchi, Antonio; Salis, Paola; Gastaldon, Fiorella; Mallamaci, Francesca; Strologo, Luca Dello; Taglioni, Chiara; Teresa, Papalia; Peruzzi, Licia; Gesualdo, Loreto; Gotti, Eliana; Feltracco, Paolo; Paoletti, Ernesto

doi:10.1007/s40620-020-00755-8

Cited by 44 publications

(53 citation statements)

References 44 publications

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“…The Italian survey has highlighted that most of transplant centers have drastically diminished their activity, especially in the areas where the incidence of COVID-19 infection was higher [ 5 ]. Our center is situated in a region with moderate risk, so we have decided to continue with our activity regarding deceased donor transplants, however making a more careful selection of donors and recipients.…”

Section: Discussionmentioning

confidence: 99%

“…The immunosuppressive agents usually used to reduce the incidence of rejection of transplanted organs reduce also the immunological response of the patient, increasing its susceptibility to opportunistic infections [ 19 ]. All the data show the need to reduce the immunosuppression therapy in symptomatic and asymptomatic patients [ 5 , 20 – 23 ]. As we did not have any infected patient at the moment, we have administered the usual immunosuppressive therapy, at the minimum effective doses [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Even our only preemptive patient decided to delay the transplantation till the end of the lockdown, accepting the probability of starting dialysis treatment. The temporary suspension of elective living donor transplantation is supported by the most recent recommendations worldwide [ 5 , 15 , 25 – 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…A recent Italian survey and consensus has tried to fill some gaps about this disease in transplanted patients. The authors have highlighted a decrease of the transplantation activities, especially for living donor transplants, and have presented some recommendation [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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[Retracted] COVID‐19 and Living Donor Kidney Transplantation in Naples during the Pandemic

Peluso

Campanile

Scotti

et al. 2020

BioMed Research International

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Introduction. SARS-CoV-2 is a virus that causes a potentially deadly syndrome that affects especially the respiratory tract. Kidney-transplanted patients are immunosuppressed and more susceptible to viral infections. We have examined our transplantation activity to explore the future role of kidney transplantation from deceased and living donors in COVID-19 era. Patients and Methods. The activity of our transplant center of Naples (one of the two transplant centers in Campania, South Italy) continued during the COVID-19 pandemic. We have analysed the kidney transplants carried out between March 9 and June 9, 2020, comparing these data with the numbers of procedures performed in the two previous years. Moreover, we have considered the possibility of performing living donor transplants during a worldwide pandemic. Results. From March 9, 2020, when the Italian lockdown begun, till June 9, 2020, five kidney transplants have been performed at our transplant center in Naples, all from deceased donors. The donors and the recipients have been screened for COVID-19 infection, and the patients, all asymptomatic, followed strict preventive measures and were fully informed about the risks of surgery and immunosuppression during a pandemic. All the transplanted patients remained COVID negative during the follow-up. The number of transplants performed has been constant compared to the same months of 2018 and 2019. In agreement with the patients, we decided to postpone living donor transplants to a period of greater control of the SARS-CoV-2 spread in Italy. Conclusion. Deceased donor kidney transplantation should continue, especially in a region with moderate risk, like Campania, with a more careful selection of donors and recipients, preferring standard donors and recipients without severe comorbidities. Living donor transplantation program, instead, should be postponed to a period of greater control of the SARS-CoV-2 spread, as it is an elective surgery and its delay does not determine additional risks for patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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[Retracted] COVID‐19 and Living Donor Kidney Transplantation in Naples during the Pandemic

Peluso

Campanile

Scotti

et al. 2020

BioMed Research International

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“…3 panel C), even though the overall rate (0.86% [95% CI 0.76-0.99]) was the lowest observed among treatment modalities. About three-quarters of the 218 SARS-Cov-2 positive Tx patients were observed in two regions: Lombardia (131) and Piemonte (31). In five regions no cases were registered.…”

Section: Kidney Transplantmentioning

confidence: 98%

Exposure to novel coronavirus in patients on renal replacement therapy during the exponential phase of COVID-19 pandemic: survey of the Italian Society of Nephrology

Quintaliani

Reboldi

Napoli³

et al. 2020

J Nephrol

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Background Between February and April 2020, Italy experienced an overwhelming growth of the COVID-19 pandemic. Little is known, at the country level, where and how patients on renal replacement therapy (RRT) have been mostly affected. Methods Survey of the network of Nephrology centers using a simplified 17 items electronic questionnaire designed by Italian Society of Nephrology COVID-19 Research Group. We used spatial epidemiology and geographical information systems to map SARS-CoV-2 spread among RRT patients in Italy. Results On April 9th 2020, all nephrology centers (n = 454) listed in the DialMap database were invited to complete the electronic questionnaire. Within 11 days on average, 365 centers responded (80.4% response rate; 2.3% margin of error) totaling 60,441 RRT patients. The surveyed RRT population included 30,821 hemodialysis (HD), 4139 peritoneal dialysis (PD), and 25,481 transplanted (Tx) patients respectively. The proportion of SARS-CoV-2 positive RRT patients in Italy was 2.26% (95% CI 2.14-2.39) with significant differences according to treatment modality (p < 0.001). The proportion of patients positive for SARS-CoV-2 was significantly higher in HD (3.55% [95% CI 3.34-3.76]) than PD (1.38% [95% CI 1.04-1.78] and Tx (0.86% [95% CI 0.75-0.98]) (p < 0.001), with substantial heterogeneity across regions and along the latitude gradient (p < 0.001). In RRT patients the highest rate was in the northwest (4.39% [95% CI 4.11-4.68], followed by the northeast (IR 2.06% [1.79-2.36]), the center (0.91% [0.75-1.09]), the main islands (0.67% [0.47-0.93]), and the south (0.59% [0.45-0.75]. During the COVID-19 pandemic, among SARS-Cov-2 positive RRT patients the fatality rate was 32.8%, as compared to 13.3% observed in the Italian population as of April 23rd. Conclusions A substantial proportion of the 60,441 surveyed RRT patients in Italy were SARS-Cov-2 positive and subsequently died during the exponential phase of COVID-19 pandemic. Infection risk and rates seems to differ substantially across regions, along geographical latitude, and by treatment modality.

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Renal involvement in COVID-19: focus on kidney transplant sector

et al. 2021

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Introduction Kidney transplant recipients and patients on the waiting list for kidney transplant who acquire SARS-CoV-2 infection are at serious risk of developing severe COVID-19, with an increased risk of mortality for the their immunosuppressive state; other risk factors for mortality have been identified in some comorbidities such as obesity, diabetes, asthma and chronic lung disease. Materials and Methods The COVID-19 pandemic has led to a sharp reduction in kidney transplants in most countries, mainly due to the concern of patients on the waiting list for their potential increased susceptibility to acquire SARS-CoV-2 infection in healthcare facilities and for the difficulties of transplant centers to ensure full activity as hospitals have had to focus most of their attention on COVID-19 patients. Indeed, while the infection curve continued its exponential rise, there was a vertical decline in kidney donation/transplant activity. Conclusion This review article focuses on the damage induced by SARS-CoV-2 infection on kidney and on the adverse effect of this pandemic on the entire kidney transplant sector.

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COVID-19 and kidney transplantation: an Italian Survey and Consensus

Cited by 44 publications

References 44 publications

[Retracted] COVID‐19 and Living Donor Kidney Transplantation in Naples during the Pandemic

[Retracted] COVID‐19 and Living Donor Kidney Transplantation in Naples during the Pandemic

Exposure to novel coronavirus in patients on renal replacement therapy during the exponential phase of COVID-19 pandemic: survey of the Italian Society of Nephrology

Renal involvement in COVID-19: focus on kidney transplant sector

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