Detection of Transmissible Severe Acute Respiratory Syndrome Coronavirus-2 From Deceased Kidney Donors: Implications for Kidney Transplant Recipients

Azhar, Ambreen; Kleiboeker, Steve; Khorsandi, Shiba; Kilpatrick, M. Duncan; Khan, Aamir; Gungor, Ahmet B.; Molnar, Miklos Z.; Morales, Megan; Levy, Marlon F.; Kamal, Layla; Moinuddin, Irfan; Kumar, Dhiren; Tanrıöver, Bekir; Gupta, Gaurav

doi:10.1097/tp.0000000000004422

Cited by 2 publications

(4 citation statements)

References 6 publications

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“…Some transplant providers may be concerned that recipients of organs from SARS-CoV-2-infected donors are similarly at risk of thrombotic events, especially given that two of 26 kidney recipients developed venous thromboembolism in a previous report. 16 With only one (pulmonary) thromboembolism in this study, which occurred 52 days after transplant in a recipient without COVID-19, we found no evidence for higher thromboembolic risk when using SARS-CoV-2-infected donor kidneys.…”

Section: Discussioncontrasting

confidence: 59%

“…University of Utah administered apixaban postoperatively for 1 month because of concern about the higher risk of thromboembolism reported in recipients of kidneys from donors with COVID-19. 16…”

Section: Data Source and Study Populationmentioning

confidence: 99%

“…In addition to the reported safety of transplanting kidneys from donors with COVID-19, case reports and series have provided some evidence for good short-term recipient outcomes. [11][12][13][14][15][16] Moreover, largescale studies using the US Organ Procurement and Transplantation Network database have revealed graft and patient survival of recipients of kidneys from SARS-CoV-2 RNA-positive donors that were comparable with those from SARS-CoV-2 RNA-negative donors. [4][5][6]22 However, a more recent singlecenter retrospective study revealed acceptable but worse short-term graft function for recipients of kidneys from SARS-CoV-2 RNA-positive donors with COVID-19-related cause of death compared with those from SARS-CoV-2 RNA-negative donors.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10] Clinical practice in many centers soon evolved toward transplanting kidneys from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA-positive donors and from those who died of COVID-19. [11][12][13][14][15][16][17] To date, despite evidence suggesting that SARS-CoV-2 infects not only the lung but also extrapulmonary organs, [18][19][20][21] no COVID-19 transmission has been reported from infected donors to negative recipients of non-lung solid-organ transplants.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Short-Term Outcomes in Kidney Transplant Recipients from SARS-CoV-2–Infected versus Noninfected Deceased Donors

Yamauchi

Azhar

Hall

et al. 2023

CJASN

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Background Acceptable posttransplant outcomes were reported in kidney transplant recipients from donors with coronavirus disease-2019 (COVID-19), however, there are no comparative studies with well-matched controls. Methods This multicenter, prospective observational study, which included three transplant centers in the US, enrolled 61 kidney recipients from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected deceased donors. Using optimal matching methods, we matched every recipient to three comparators receiving kidneys from SARS-CoV-2-negative deceased donors with otherwise highly similar characteristics within the same transplant centers to compare 6-month eGFR. Results Among recipients of SARS-CoV-2-infected donor kidneys, one recipient died with a functional graft within 6 months. Mean 6-month eGFR was not significantly different between SARS-CoV-2-infected and non-infected donor groups (55±21 and 57±25 mL/min/1.73m2; p=0.61). Six-month eGFR in recipients from SARS-CoV-2-infected donors who died from reasons other than COVID-19 was not significantly different from those from SARS-CoV-2-negative donors (58±22 and 56±25 mL/min/1.73m2; p=0.51). However, recipients from donors who died from COVID-19 had significantly lower 6-month eGFR that those from SARS-CoV-2-negative donors (46±17 and 58±27 mL/min/1.73m2; p=0.03). No donor-to-recipient SARS-CoV-2 transmission was observed. Conclusions Six-month eGFR was not significantly different between recipients of kidneys from SARS-CoV-2-infected and non-infected donors. However, those receiving kidneys from donors who died from COVID-19 had significantly lower 6-month eGFR. Donor-to-recipient SARS-CoV-2 transmission was not observed.

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Section: Discussioncontrasting

confidence: 59%

Section: Data Source and Study Populationmentioning

confidence: 99%