Telemedicine monitoring in the follow-up of kidney transplant recipients: consensus indications from an Italian panel of surgeons and nephrologists after the COVID-19 experience

Luigi Biancone,Marco Volpe,Franco Citterio,Enrico Minetti,Giovanni Stallone,Paride De Rosa,Paolo Rigotti

doi:10.1007/s40620-021-01193-w

Abstract

The quality of follow-up has clearly emerged as a key factor for long-term kidney graft survival. Currently, many clinics are facing difficulties in delivering optimal surveillance because of the increased number and complexity of kidney transplant recipients, and because of the COVID-19 pandemic. Additional ways of performing follow-up visits are needed and telemedicine has emerged as a tool to strengthen patient care intensity. Six Italian transplant surgeons and nephrologists convened via teleconference to develop a consensual model of video visits for the follow-up of kidney transplant recipients. Issues discussed were: profile of eligible patients; assessments that can be carried out; video visit organization and medical professionals involved; supporting tools and implementation. The video visit was consensually recognized as the most relevant for the follow-up of kidney transplant recipients. Eligible patients should have basic electronic devices and the skills to correctly use them and be in clinically stable condition. With the exception of physical and instrumental examination, and kidney biopsy, all other assessments are feasible during a video visit and can be implemented by specific training and use of supporting tools. The video visit model is simple and adaptable to most transplant patients. It is not intended to replace face-to-face examinations, but is an additional tool for improving the intensity of follow-up of kidney transplant recipients, which can be integrated into current monitoring protocols.Graphical abstract

Highlights

Kidney transplant recipients need life-long follow-up after transplantation to avoid acute graft rejection and opportunistic infections, optimize renal function, ensure compliance to prescribed treatments, and prevent the long-term complications of immunosuppressive therapy [1]
Considering current telemedicine regulations in Italy, relevant issues concerning the video visit, the profile of kidney transplant recipients, assessments that can safely be performed remotely, and the required infrastructures, here we report the consensus-based model of video visits
During 2020, six transplant surgeons and nephrologists from six different Italian regions convened in a scientific webinar to address post-operative monitoring of kidney transplant recipients in the current situation of work overload and general healthcare crisis generated by the COVID-19 pandemic

Summary

Introduction

Kidney transplant recipients need life-long follow-up after transplantation to avoid acute graft rejection and opportunistic infections, optimize renal function, ensure compliance to prescribed treatments, and prevent the long-term complications of immunosuppressive therapy [1]. The healthcare crisis generated by the outbreak of Coronavirus disease 2019 (COVID-19) has further complicated the follow-up of kidney transplant recipients, increasing the need for alternatives to conventional face-to-face medical visits.

Results

Conclusion