Kidney Transplant after a COVID-19

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Background 

Kidneys are crucial for filtering out harmful waste material and excess fluids from the body. Many conditions including diabetes, hypertension, and obesity can impair the filtering capacity of kidneys. Chronic kidney disease (CKD) also called renal failure or kidney failure is a slowly progressive loss in kidney functions resulting in the building-up of harmful fluids and waste products in the body. It affects multiple organs and can eventually death if left untreated. 

Life-long dialysis and kidney transplantation are two treatment options for kidney failure. Comparatively, a kidney transplant is a better choice of treatment and involves surgically replacing a diseased kidney with a healthy kidney that is received from a living person (living donor) or someone who has recently died (deceased or cadaver donor). 

Benefits of Kidney Transplantation

Kidney transplantation is the best therapeutic option for patients with end-stage kidney disease and has numerous benefits such as:

  • Does not require lifelong dialysis treatment.

  • Compared to patients who are on life-long dialysis treatment, kidney transplantation patients live longer with an average life expectancy of 10 to 15 years. 

  • Higher energy levels and enthusiasm to do regular day-to-day activities.

  • Fewer dietary restrictions

  • Sometimes the end-stage kidney disease can also cause end-stage liver disease. For treating such patients with multiple organ dysfunction, simultaneous replacement of more than one organ (e.g., combined kidney and liver transplantation) gives them multiple benefits including single surgery and usage of lower immunosuppression dose. 

Risks of Delaying Kidney Transplantation

In chronic kidney disease, the kidneys have lost around 90% of their filtering functions. Delay in treatment can cause a build-up of the high content of calcium, sodium, potassium, and fluid in the body which is life-threatening. It can also result in heart problems, bone diseases, anaemia, etc. It is, therefore, imperative for patients suffering from chronic kidney diseases not to avoid or postpone kidney transplantation. 

Impact of COVID-19 Pandemic on Kidney Transplantation

Organ donation and transplantation programs have suffered a major setback owing to the coronavirus disease 2019 (COVID-19) pandemic. Global data suggests a drop of about 51-91% in various countries during the first peek of the pandemic. Another report suggests a 2.2 times higher risk of death among patients awaiting kidney transplants during the pandemic. 

Most of the hospitals in India and around the world temporarily suspended kidney transplantation related activities as the intensive care units and hospital wards were dedicated exclusively to the care of COVID-19 patients. In addition, the fear of contracting COVID-19 infection kept people suffering from kidney diseases from visiting hospitals for treatments. 

Is it safe to undergo a kidney transplant during the COVID-19 pandemic?

There are many causes of a successful kidney as well as combined kidney and liver transplants during the pandemic. Even after recovering from COVID - 19 infection, many patients with stage 5 chronic kidney failure have undergone successful transplantation without requiring additional dialysis treatment, post-operatively. 

Safety Protocols for Safe Kidney Transplantation During the COVID-19 Pandemic

Hospitals are following exceptional and aggressive safety protocols to protect their patients during the COVID-19 pandemic. 

  • Both the donor and the recipient are aggressively screened for COVID-19 symptoms and exposure history, such as travel history.

  • Before kidney transplant, in the donor and the recipient, active COVID-19 infection is ruled out with a negative RT-PCR test and absence of symptoms for at least 3 days or 72 hours. 

  • If the kidney patient or the donor is COVID-19 positive, the transplant will not be performed until a complete cure occurs. After at least 14 days of the onset of symptoms, and a negative RT-PCR report (which is repeated 2 - 3 times consecutively to conform results), the transplantation is performed.  

  • Due to virtual evaluations of both the potential kidney donors and recipients, via video or phone, the hospital visits are less frequent and shorter which prevents chances of infection.

  • Because kidney transplant patients take immunosuppressive drugs, they may be at a higher risk for infection. To prevent this, the patient is educated on the importance of wearing a face mask, hand hygiene, coughing and sneezing etiquette.

  • The dialysis centre, ICU, and the hospital premises are aggressively disinfected regularly, beds are arranged at a good distance with no attendant policy to prevent the spread of infection. 

  • A separate ICU is maintained for kidney transplant patients. 

Conclusion

Transplantation is a life-saving procedure and its benefits outweigh the risk of contracting the COVID-19 infection in the current scenario. The ongoing vaccination drive and the standard safety protocols being followed have reduced the chances of contracting severe COVID-19 largely. Most International guidelines recommend not to postpone transplantation procedures in high-risk patients to delay complications. Overall, it is safe for both the donors and the recipient to come forward for kidney transplantation or combined kidney and liver transplantation at present. Visit the Best Kidney Transplant Hospital in Bangalore if you have any queries.

If you are looking for a Kidney Transplant in Old Airport Road, Bangalore then consult Manipal Hospital where they have the Best Doctor for Kidney Transplants in Bangalore who have years of experience in kidney transplants.


Dr. Vishwanath S

HOD & Consultant - Nephrology, Transplant Physician

Manipal Hospital, Old Airport Road, Bangalore

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