COVID-19 outcomes in patients waitlisted for kidney transplantation and kidney transplant recipients.
clinical decision-making
clinical research/practice
kidney transplantation/nephrology
patient survival
waitlist management
Journal
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
ISSN: 1600-6143
Titre abrégé: Am J Transplant
Pays: United States
ID NLM: 100968638
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
revised:
21
09
2020
received:
24
07
2020
accepted:
05
10
2020
pubmed:
13
10
2020
medline:
28
4
2021
entrez:
12
10
2020
Statut:
ppublish
Résumé
The COVID-19 pandemic has brought unprecedented challenges to the transplant community. The reduction in transplantation volume during this time is partly due to concerns over potentially increased susceptibility and worsened outcomes of COVID-19 in immunosuppressed recipients. The consequences of COVID-19 on patients waitlisted for kidney transplantation, however, have not previously been characterized. We studied 56 waitlisted patients and 80 kidney transplant recipients diagnosed with COVID-19 between March 13 and May 20, 2020. Despite similar demographics and burden of comorbidities between waitlisted and transplant patients, waitlisted patients were more likely to require hospitalization (82% vs. 65%, P = .03) and were at a higher risk of mortality (34% vs. 16%, P = .02). Intubation was required in one third of hospitalized patients in each group, and portended a very poor prognosis. The vast majority of patients who died were male (84% waitlist, 100% transplant). Multivariate analysis demonstrated waitlist status, age, and male sex were independently associated with mortality. COVID-19 has had a dramatic impact on waitlisted patients, decreasing their opportunities for transplantation and posing significant mortality risk. Understanding the impact of COVID-19 on waitlist patients in comparison to transplant recipients may aid centers in weighing the risks and benefits of transplantation in the setting of ongoing COVID-19.
Identifiants
pubmed: 33043597
doi: 10.1111/ajt.16351
pmc: PMC7675359
pii: S1600-6135(22)08505-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1576-1585Informations de copyright
© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.
Références
J Allergy Clin Immunol. 2020 Jul;146(1):110-118
pubmed: 32294485
Virus Res. 2014 May 12;184:44-53
pubmed: 24566223
Lancet. 2020 May 23;395(10237):e95-e96
pubmed: 32407668
N Engl J Med. 2020 Jun 11;382(24):2372-2374
pubmed: 32302078
Am J Transplant. 2020 Nov;20(11):3131-3139
pubmed: 32594606
Eur Heart J. 2020 May 14;41(19):1818-1820
pubmed: 32388547
J Am Soc Nephrol. 2020 Jul;31(7):1409-1415
pubmed: 32467113
J Intensive Care. 2020 May 24;8:36
pubmed: 32483488
Antiviral Res. 2018 Feb;150:155-163
pubmed: 29289665
Front Public Health. 2020 Apr 29;8:152
pubmed: 32411652
Am J Transplant. 2020 Nov;20(11):3265-3266
pubmed: 32515039
Nephrol Dial Transplant. 2013 Apr;28(4):770-3
pubmed: 23109559
Int J Antimicrob Agents. 2020 Apr;55(4):105946
pubmed: 32199877
Virus Res. 2012 Apr;165(1):112-7
pubmed: 22349148
Nephrol Dial Transplant. 2018 Oct 1;33(suppl_3):iii35-iii40
pubmed: 30281126
Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Feb 10;41(2):145-151
pubmed: 32064853
Am J Kidney Dis. 2020 Jul;76(1):141-143
pubmed: 32240718
J Med Virol. 2020 Jun;92(6):577-583
pubmed: 32162702
Antiviral Res. 2015 Mar;115:9-16
pubmed: 25542975
Int J Infect Dis. 2020 Jul;96:467-474
pubmed: 32425643
Nephrol Dial Transplant. 2020 Jul 1;35(7):1250-1261
pubmed: 32678882
Kidney Int. 2020 Jul;98(1):27-34
pubmed: 32437770
Nat Rev Nephrol. 2013 May;9(5):255-65
pubmed: 23507826
Am J Transplant. 2020 Nov;20(11):2997-3007
pubmed: 32515544