Table 1.
Kidney transplantation in candidates with recovered or positive SARS-CoV-2 infection. COVID-19 severity was defined as asymptomatic in cases who had incidental detection, mild in those with only upper respiratory symptoms, moderate when requiring low flow oxygen, and severe in cases with higher oxygen requirement. * = Cases which were RT-PCR positive at the time of transplant surgery. Abbreviations: COVID-19, coronavirus disease; CKD, chronic kidney disease; CT, cycle threshold; DM, diabetes mellitus; DD, deceased donation; ESKD, end-stage kidney disease; F, female; HD, hemodialysis; IS: immunosuppression; LD, living donation; M, male; m, months; MMF, mycophenolate; nRT-PCR, real-time polymerase chain test through nasopharyngeal specimen; MN, membranous nephropathy; TIN, tubulointerstitial nephritis; TCR, T cell rejection
| Authors | n | Type | Age/sex | Cause of ESKD | COVID-19 severity | Negative nRT-PCR prior to transplant | Waiting time after a negative RT-PCR | IgG antibody test Pre-Transplant |
Donor’s COVID-19 status | IS regimen | Outcome | Follow-up |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
Singh N et al., Sept 2020 [20] |
1 | DD | 66/F | DM | Mild (home) | 2 negatives (24 h apart) | 3 mos | Done (positive) | Negative | No change | Uneventful | 7 wks |
|
Varotti et al., Oct 2020 [16] |
1 | DD | 28/F | MN- CKD | Mild | 2 negative (48 h apart) | 2 wks | Done (positive) | Negative | No change | E. coli infection | 60 d |
|
Waghmare I et al., Dec 2020 [12] |
1 | LD | 46/M | Not reported | Severe | ≥ 2 | 3 mos | Not reported | Negative | No change | Uneventful | 1 mos |
|
Kanchi et al., Jan 2021 [66] |
2 |
• DD • LD |
• 44/M • 35/F |
• DM • CKD unknown |
• Severe • Mild |
• 2 negatives • 3 negatives |
• 4 wks • 6 wks. of COVID-19 diagnosis |
Done (positive) in both |
• Negative • Positive |
• No change • No induction |
• Uneventful • Uneventful |
• 15 wks • 14 wks |
|
Viana L A et al., Jan 2021* [61] |
4 | DD |
• 34/M • 27/M • 41/M • 65/F |
Not reported |
• Mild • Mid • Asymptomatic • Asymptomatic |
All 4 cases were RT-PCR positive retrospectively after surgery | - | Not done | Negative in all | In 3 cases, MMF was halved | Two patients got TCR | 1 mo |
|
Kucuk et al., Feb 2021 [11] |
1 | LD | 31/M | CKD unknown | Mild | 4 negatives | 30 d after recovery | Done (both negative) | Positive with mild illness | No change | None | 45 d |
|
Murad et al., Feb 2021* [18] |
1 | DD | 64/F | Alport syndrome | Mild | Positive (high CT value) | 6 wks. after COVID-19 | Not reported | Negative | No change | Uneventful | 4 mo |
|
Yoshinaga et al., March 2021 [67] |
1 | DD | 49/M | Not reported | Moderate | 3 | 3 mos | Not done | Negative | No change | Uneventful | 95 d |
|
Reyad Al et al., March 2021 [68] |
1 | DD | 65/F | CKD unknown | Severe | 3 | 46 d | Positive | Negative | No change | Uneventful | 2 mos |
|
Kute et al., April 2021 [13•] |
9 of 31 | LD |
Median: 39 yr Sex: M:7 F:2 |
HTN and DM |
• Asymptomatic (n = 5) • Mild (n = 4) |
≥ 2 | 73 (34–92) d | Not mandatory | All donors were COVID-19 recovered | No change | Uneventful | 44 d |
|
Villanego F et al., May 2021 [69] |
1 | DD | 70/M | Chronic TIN | Asymptomatic | 3 consecutive negatives | 3 mos. after first + ve | Done (positive) | Negative | No change | Uneventful | 2 mos |
|
Santeusanio AD et al., June 2021 [15••] |
13 |
• DD:10 • LD: 3 |
Median: 2.8 yr Sex: 84% M |
• HTN (38%) • DM (30%) |
• Mild (n = 9) • Moderate–severe (n = 3) • Mechanical ventilation (n = 1) |
1 Negative | Median of 71 (56.6–135) d | 10 out of 13; and all reports positive for antibodies | Negative | No change | Uneventful: no difference vs controls | 3.6 mos |
|
Puodziukaite et al., June 2021 [19] |
2 | DD |
• 38/F • 36/M |
• DM • IgA nephropathy |
• Mild • Asymptomatic |
1 Negative |
• 2.5 mos. after COVID-19 • 2 mos. after COVID-19 |
Done (positive) |
• RT-PCR + ve • Mild |
No change | Uneventful | 3 mos |
|
Hogan et al., July 2021* [17] |
1 | DD | 8/M | Congenital nephrotic syndrome | Asymptomatic | Positive with high CT value | Active; RT-PCR + ve with high CT value | Done (positive) | Negative | No change | Uneventful | 44 d |
|
Tuschen et al., July 2021 [70] |
1 | DD | 65/F | IgA nephritis | Moderate | 3 | 65 d | Positive | Negative | No change | Uneventful | 9 mos |
|
Kute et al., July 2021 [14••] |
75 | LD |
Median: 47 (29–72) Sex: M:23 F:52 |
• Not reported • Indication of early transplant: Difficult vascular access (n = 8) and severe left ventricular dysfunction (n = 12); Others: Financial constraint for continuing HD |
• Asymptomatic (n = 17, 22.7%) • Mild (n = 3, 6.48%) • Moderate (n = 1, 5.20%) • Severe (n = 7, 9.3%) |
≥ 2 |
Median: 60 d; Increased significantly from asymptomatic, mild, moderate, and severe disease (49, 57, 83, 94 d; P = 0.019), respectively |
Not mandatory | COVID-19 recovered donors (n = 16) | No change | Uneventful | Median: 81 d (56–117) |