SUCCESSFUL RENAL TRANSPLANTATION SEVEN WEEKS AFTER COVID-19 PNEUMONIA

Introduction: COVID-19 presents a new challenge to transplantation medicine Patients with kidney transplants and those requiring dialysis do not seem to be more prone to infection with SARS-CoV-2, but case mortality rate is significantly higher Since the beginning of the global pandemic, dialysis patients have to face the additional problem of a reduced chance of receiving a transplant because organ offers have plummeted Transplant centers have also temporarily reduced their activity also in order not to put dialysis patients at increased risk due to hospital admission and immunosuppressive therapy Results: In May 2020, a 65-year-old dialysis patient received a kidney from a 70-year-old deceased donor with an eGFR of 94 ml/min The recipient herself was hospitalised for 14 days due to COVID-19 pneumonia and discharged only 6 weeks before the organ offer Her course had been mild with nasal oxygen supply and without need high-flow therapy or NIV At the time of the transplantation, the patient was completely symptom-free with no evidence of residual signs of infection Chest X-ray did not show infiltrates The transplantation was without complications with an immunosuppressive regimen consisting of Tacrolimus, mycophenolate and steroids after induction with Basiliximab The graft achieved primary function with a serum creatinine of 1 5 mg/dl at discharge While SARS-CoV-2 PCR in the throat gargle sample remained negative, antibody testing for SARS-CoV-2 IgG was positive In the short-term course, the patient developed no evidence of recurrent symptoms of COVID-19 Conclusion: After full recovery of COVID-19 pneumonia, it is still unclear whether and for long immunity occurs Moreover, it is unknown whether recovered patients are at risk for reinfection and how long transplantation should be delayed Since there is no evidence of virus persistence in the literature, we decided to proceed with transplantation at this very early time Although our follow up period is very short, we feel that the benefits of a successful transplant outweighed the existing risks Long-term follow up will provide important insights into the course of immune responses to SARS-CoV-2 after renal transplantation