Health
Kidney Transplantation in the Age of COVID-19: Dilemmas, Experiences, Prospects-Cristelli-Transplant Infections
Preface
Hospital do Rim is a mass kidney transplant (KT) center in the city of São Paulo with a population of 12.2 million. Over the last 18 years, 11,436 kidney transplants have been performed, 70% from deceased donors. Sequential measures were taken when COVID-19 was declared a pandemic to mitigate the impact of the reduced number of ports on the wait list.
Method
The first step was to provide all symptomatic employees and patients with SARS-COV-2 RT-PCR testing and to force the use of personal protective equipment in hospital facilities. Living donor KT was postponed and all dead donors and recipients were examined prior to transplantation. The immunosuppressive protocol was maintained and a telemedicine strategy was developed.
result
Of the 1013 employees, there were 214 COVID-19s, 9 ward admissions required, and no deaths. At 26%, the potential source of pollution was professional. From the first patient diagnosed with COVID-19 on March 20, 2020, 523 deaths were performed by October 21, 2020, an increase of 21% compared to 2019, and donor-derived SARS. -No CoV-2 infection was confirmed. Four patients were transplanted with a positive SARS-CoV-2 test before transplantation, but none developed the disease. Overall, of the 11,875 KT tracked at our center, 674 developed COVID-19. Of the inpatients, 53% needed mechanical ventilation and 45% needed hemodialysis. The overall mortality rate was 27.5%.
Conclusion
This experience demonstrates the challenges faced by transplant centers when a pandemic occurred and the effectiveness of a series of measures taken to provide a safe environment for transplants.
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