Is it Safe to Be Transplanted From Living Donors Who Recovered From COVID-19? Experience of 31 Kidney Transplants in a Multicenter Cohort Study From India

Transplantation. 2021 Apr 1;105(4):842-850. doi: 10.1097/TP.0000000000003609.

Abstract

Background: There is lack of data on feasibility and safety of kidney transplants from living donors who recovered from COVID-19.

Methods: Here, we present a retrospective cohort study of 31 kidney transplant recipients (KTR) from living donors who recovered from polymerase chain reaction confirmed COVID-19 across 19 transplant centers in India from July 3, 2020, to December 5, 2020. We detailed demographics, clinical manifestations, immunosuppression regimen, treatment, and outcomes. Donors with a previous diagnosis of COVID-19 were accepted after documenting 2 negative polymerase chain reaction tests with complete symptom resolution for at least 28 days and significant social distancing for 14 days before surgery.

Results: COVID-19 clinical severity in donors ranged from completely asymptomatic (71%, n = 22) to mild infection (29%, n = 9). None progressed to moderate or severe stages of the disease in the entire clinical course of home treatment. Patient and graft survival was 100%, respectively, with acute cellular rejection being reported in 6.4% (n = 2) recipient. All recipients and donors were asymptomatic with normal creatinine at median follow-up of 44 days after surgery without any complications relating to surgery and COVID-19.

Conclusions: Our data support safety of proceeding with living donation for asymptomatic individuals with comprehensive donor, recipients screening before surgery, using a combination of clinical, radiologic, and laboratory criteria. It could provide new insights into the management of KTR from living donors who have recovered from COVID-19 in India. To the best of our knowledge, this remains the largest cohort of KTR from living donors who recovered from COVID-19.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology
  • COVID-19 / transmission*
  • COVID-19 Testing
  • Child
  • Cohort Studies
  • Disease Transmission, Infectious
  • Female
  • Humans
  • India / epidemiology
  • Kidney Transplantation / adverse effects*
  • Living Donors
  • Male
  • Middle Aged
  • Pandemics
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2*
  • Safety
  • Tissue and Organ Procurement*
  • Transplant Recipients
  • Young Adult