Kidney transplantation using lymphocyte depleting induction and standard maintenance immunosuppression at the height of the SARS‐CoV‐2 pandemic in New York City: A single‐center experience

• Published in: Clinical transplantation Vol. 34; no. 9; pp. e14055 - n/a
• Main Authors: Santeusanio, Andrew D., Zendel, Alexey, Fenig, Yaniv, Mahamid, Ahmad, Bhansali, Arjun, De Boccardo, Graciela, Delaney, Veronica, Farouk, Samira S., Dunn, Dallas, Rana, Meenakshi, Florman, Sander, Shapiro, Ron
• Format: Journal Article
• Language: English
• Published: Denmark 01.09.2020
• Subjects: Adult; Aged; COVID-19 - complications; COVID-19 - mortality; COVID-19 - therapy; COVID‐19; Female; Graft Rejection; Graft Survival; Humans; immunosuppressive agents; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - mortality; Kidney Failure, Chronic - surgery; Kidney Transplantation; Lymphocyte Depletion; Male; Middle Aged; New York City - epidemiology; Retrospective Studies; SARS-CoV-2; Survival Rate; transplant recipients; New York City; immunosuppressive agents; transplant recipients; COVID‐19; kidney transplantation
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/ctr.14055

Background Concerns have been raised regarding proceeding with kidney transplantation using standard immunosuppression in COVID‐19 endemic areas. Methods We performed a single‐center review of all adult kidney transplants performed during the COVID‐19 pandemic in New York City. Patients were managed with standard immunosuppression protocols, including lymphocyte depleting induction and trough‐guided tacrolimus. Retrospective data were collected for 3 months from the date of transplantation or until study conclusion (5/7/2020). The primary outcomes assessed included patient and allograft survival as well as COVID‐19 related hospital readmission. Results 30 kidney transplants were performed during the height of the COVID‐19 pandemic. After a median follow‐up of 51.5 days, 93.3% of patients were alive with 100% death‐censored allograft survival. 9 patients were readmitted to the hospital during the study period, 4 (13.3%) related to infection with COVID‐19. Infections were mild in 3/4 patients, with one patient developing severe disease leading to respiratory failure. Patients readmitted with COVID‐19 were numerically more likely to be African American, have a BMI > 30 kg/m2, have a lymphocyte count ≤ 300 cells/mL, and be on maintenance corticosteroids. Conclusions Kidney transplantation in areas endemic to COVID‐19 using standard induction and maintenance immunosuppression appears to be associated with a modest risk for severe COVID‐19 related disease.