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Emerging data support the safety of transplantation of extra‐pulmonary organs from donors with SARS‐CoV‐2‐detection. Our center offered kidney transplantation (KT) from deceased donors (DD) with SARS‐CoV‐2 with and without COVID‐19… Click to show full abstract
Emerging data support the safety of transplantation of extra‐pulmonary organs from donors with SARS‐CoV‐2‐detection. Our center offered kidney transplantation (KT) from deceased donors (DD) with SARS‐CoV‐2 with and without COVID‐19 as a cause of death (CoV + COD and CoV+) to consenting candidates. No pre‐emptive antiviral therapies were given. We retrospectively compared outcomes to contemporaneous DDKTs with negative SARS‐CoV‐2 testing (CoVneg). From February 1, 2021 to January 31, 2022, there were 220 adult KTs, including 115 (52%) from 35 CoV+ and 33 CoV + COD donors. Compared to CoVneg and CoV+, CoV + COD were more often DCD (100% vs. 40% and 46%, p < .01) with longer cold ischemia times (25.2 h vs. 22.9 h and 22.2 h, p = .02). At median follow‐up of 5.7 months, recipients of CoV+, CoV + COD and CoVneg kidneys had similar rates of delayed graft function (10.3%, 21.8% and 21.9%, p = .16), rejection (5.1%, 0% and 8.5%, p = .07), graft failure (1.7%, 0% and 0%, p = .35), mortality (0.9%, 0% and 3.7%; p = .29), and COVID‐19 diagnoses (13.6%, 7.1%, and 15.2%, p = .33). Though follow‐up was shorter, CoV + COD was associated with lower but acceptable eGFR on multivariable analysis. KT from DDs at various stages of SARS‐CoV‐2 infection appears safe and successful. Extended follow‐up is required to assess the impact of CoV + COD donors on longer term graft function.