Our renal transplant protocols during COVID-19 times – A prospective study from high-volume tertiary center of North India

Abstract

Introduction: There is a strong temporal association between the increase in coronavirus disease-2019 (COVID-19) infections and a striking reduction in overall solid-organ transplantation procedure. The priority is to select uninfected donors to transplant uninfected recipients while maintaining safety for health-care systems in the backdrop of a virulent pandemic. Our current communication shares a protocol for donor and transplant recipient selection during the COVID-19 pandemic to continue lifesaving kidney transplantation. This protocol was created utilizing the guidelines of various organizations and from the clinical experience of the authors and will continue to evolve as more is understood about severe acute respiratory syndrome coronavirus 2 and how it affects organ donors and transplant recipients. Objectives: In this study, we aimed to review the published literature and compare it with our kidney transplantation is done in 115 patients in our hospital from July 2020 to February 2021 in the time of COVID-19 and what protocols we follow before transplant to reduce the risk of COVID-19 infection. This article also contains currently available immunosuppressive strategies. Methods: A prospective study was done in Mahatma Gandhi Hospital Jaipur for the transplant done from July 2020 to February 2021. A total of 115 patients from 20th July to 28th February were considered for the study. Results: All 115 patients who were COVID negative on reverse transcriptase–polymerase chain reaction assay and high-resolution computed tomography were considered for the transplant. COVID status on discharge for all 115 recipients was negative. During workup, two donors were found COVID-19 positive and were shifted to COVID center for treatment and their transplant postpone. Out of 115 renal transplant patients, only 1 patient became COVID-19 positive after 5 days of operation. Conclusions: Every transplant center should put its local policy about transplantation depending on the state of the epidemic in the country. Nowadays, transplantation programs should be limited to urgent cases. We suggest lowering the threshold for diagnosis of COVID-19 among renal transplant recipients.