Abstract
BackgroundWe aimed to evaluate the impact of COVID-19 pandemic on pediatric transplant outcomes and determine whether to continue pediatric transplant activity or not, and how policies intended our center has been effective in preventing COVID-19 among organ transplant recipients.MethodsWe conducted a single-center, retrospective, cohort study of hospitalized pediatrics after organ transplantation at Shiraz transplant center since March to August 2020. All liver and kidney transplanted children were included the study and their laboratory and clinical related COVID-19 characteristics were followed up till 3 months after transplantation during hospitalization period and then weekly by the transplant committee.ResultsFifty-one patients underwent transplantation including 11 kidney and 40 liver recipients. The mean age of the pediatric cases was 6.72 ± 5.47 years. A total of 11 patients died due to post-transplant complications, while none of the patients presented any sign or symptoms in favor of COVID-19 in the hospital course after transplantation. Six transplants including 2 kidney and 4 liver were canceled when positive PCR tests were detected in their donors before the surgery. In the 3 months of follow up, two patients presented with symptoms including high grade fever, malaise, rhinorrhea, and GI symptoms. Both patients had two negative PCR, and no radiologic or laboratory results regarding COVID-19 were also detected. One had positive influenza PCR, while the second one had a positive serologic test for EBV; CT, computed tomographyConclusionTransplant programs could continue their activities during the COVID-19 pandemic with specific case selection, accurate screening methods and following protective protocols.
Highlights
The global pandemic of the severe acute respiratory coronavirus 2 (SARS-CoV-2) has emerged as a life-threatening infection, declared as a global pandemic by the Center for World Health Organization (WHO) on March 11 [1]
The aim of the present study was to evaluate the impact of COVID-19 pandemic on pediatric transplant operations, whether to continue pediatric transplant activity or not, and transplant recipients diagnosed with COVID19 among liver and kidney transplanted children who referred to our center as the only tertiary referral hospital in Iran during March 27, 2020 and August 27, 2020 based on the clinical and laboratory data
According to the global impact of COVID-19 on our center practices, the number of liver and kidney transplantations had decreased by 25.8% and 32.1% compared to the same period last year, respectively
Summary
The global pandemic of the severe acute respiratory coronavirus 2 (SARS-CoV-2) has emerged as a life-threatening infection, declared as a global pandemic by the Center for World Health Organization (WHO) on March 11 [1]. Normally maintained in an immunosuppressed state to avoid organ rejection, are expected to be more susceptible for COVID-19 due to their immune status [6]. They might have poorer outcomes in the case of COVID-19 due to their comorbidities, while their immunosuppressive management is of a great concern [7, 8]. Dealing with this situation with respect to issues around donors or recipients, and approaches regarding new transplant should be aligned with international recommendations. We aimed to evaluate the impact of COVID-19 pandemic on pediatric transplant outcomes and determine whether to continue pediatric transplant activity or not, and how policies intended our center has been effective in preventing COVID-19 among organ transplant recipients
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