Successful Management of COVID-19 Pneumonia Following Live-Related Kidney Transplant in a 74-Year-Old Recipient

Abstract

Background: COVID-19 infection is the most recent worrying viral pandemic worldwide. Little is understood regarding the course of illness and subsequent immediate and long-term complications. Despite numerous ongoing trials, there is still no agreed mode of treatment for this viral illness. Live-donor renal transplantation is the gold standard treatment for end-stage renal disease. Those patients undergoing renal transplantation are deemed particularly high risk for contracting COVID-19 secondary to the effects of immunosuppression. This case report discusses management of COVID-19 infection in a 74-year-old male, who underwent a live-related kidney transplant. Case Presentation: A 74-year-old Caucasian male patient, developed renal failure due to diabetic nephropathy since 2012. The patient was transplanted in 2013 with a graft from a deceased donor, but unfortunately this kidney failed in 2014, aetiology unknown. Haemodialysis was recommenced until he received a second kidney transplant from a live-related donor in March 2020. Unfortunately, postoperative recovery was complicated with COVID-19 infection. The clinical signs and symptoms, along with details surrounding presentation are discussed. This includes the rationale behind the management of such highrisk immunosuppressed patients with COVID-19 infection. Conclusion: There is still no consensus about the best modality for treating COVID-19 infection in recipients of solid organ transplantation. From our experience, temporarily stopping the anti-proliferative immunosuppressant (e.g. Mycophenolate mofetil) during the acute illness seemed to enhance recovery of the acute phase of the disease.