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Our experience in the management of renal transplant recipients in the COVID-19 pandemic
Author(s) -
V. M. Lesovoy,
Ніна Михайлівна Андон’єва,
M.O. Zhelieznikova,
T.L. Valkovskaya
Publication year - 2022
Publication title -
medicina sʹogodnì ì zavtra
Language(s) - English
Resource type - Journals
eISSN - 2710-1444
pISSN - 2414-4495
DOI - 10.35339/msz.2022.91.1.laz
Subject(s) - medicine , gastroenterology , kidney , sepsis , thrombosis , kidney transplantation , respiratory system , pulmonary embolism , lung , kidney disease
169 patients with a functioning kidney transplant were observed. In 51 patients from 169 were diagnosed with COVID-19. The virus was verified by polymerase chain reaction in all patients and in 74% of cases immunoglobulins M and G were detected by immunological blood tests. Patients who underwent COVID-19 were divided into the following groups: Group 1 – kidney transplant recipients who recovered after COVID-19 (n=44); Group 2 – kidney transplant recipients who died (n=7). Lymphopenia, which was directly proportional to the severity of the disease, was observed in Group 2 patients. The serum C-reactive protein content of Group 2 patients did not differ significantly from that of Group 1. In Group 2 patients, the D-dimer content was significantly higher than that of Group 1. When we analyzed the percentage of lung lesions of the examined patients, it was found that in patients of Group 2 this figure was 68.0 [63.5; 75.0], which was probably higher than that of Group 1 patients (p<0.05). Kidney transplant dysfunction was observed in 16 recipients (31%) during the follow-up period of patients with COVID-19. Complications observed during the disease and arising from the treatment of patients accounted for 15.2%, of which thrombosis of various localizations – 1.5%, myocardial damage – 2.5%, bleeding – 3.4%. The mortality rate of kidney transplant recipients was 13.7%. The main cause of death was acute respiratory syndrome in combination with sepsis (in 8.1% of patients), pulmonary embolism (in 3.2%), and acute cerebrovascular accident (in 2.4%). According to our studies, the risk factors for an unfavorable outcome of COVID-19 are comorbid syndrome, the severity of lung damage, hyperalbuminuria, an increase in C-reactive protein, D-dimer, platelets and lymphopenia.Keywords: chronic kidney disease, kidney transplant, COVID-19.

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