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Should We Perform Old-for-Old Kidney Transplantation during the COVID-19 Pandemic? The Risk for Post-Operative Intensive Stay.
Zeuschner, Philip; Sester, Urban; Stöckle, Michael; Saar, Matthias; Zompolas, Ilias; El-Bandar, Nasrin; Liefeldt, Lutz; Budde, Klemens; Öllinger, Robert; Ritschl, Paul; Schlomm, Thorsten; Mihm, Janine; Friedersdorff, Frank.
  • Zeuschner P; Department of Urology and Pediatric Urology, Saarland University, Kirrberger Street 100, 66421 Homburg/Saar, Germany.
  • Sester U; Department of Nephrology and Hypertension, Internal Medicine IV, Saarland University, Kirrberger Street 100, 66421 Homburg/Saar, Germany.
  • Stöckle M; Department of Urology and Pediatric Urology, Saarland University, Kirrberger Street 100, 66421 Homburg/Saar, Germany.
  • Saar M; Department of Urology and Pediatric Urology, Saarland University, Kirrberger Street 100, 66421 Homburg/Saar, Germany.
  • Zompolas I; Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany.
  • El-Bandar N; Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany.
  • Liefeldt L; Department of Nephrology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany.
  • Budde K; Department of Nephrology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany.
  • Öllinger R; Department of Surgery, Campus Charité Mitte/Campus Virchow-Klinikum CCM/CVK, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany.
  • Ritschl P; Department of Surgery, Campus Charité Mitte/Campus Virchow-Klinikum CCM/CVK, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany.
  • Schlomm T; Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany.
  • Mihm J; Department of Nephrology and Hypertension, Internal Medicine IV, Saarland University, Kirrberger Street 100, 66421 Homburg/Saar, Germany.
  • Friedersdorff F; Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany.
J Clin Med ; 9(6)2020 Jun 12.
Article in English | MEDLINE | ID: covidwho-603147
Semantic information from SemMedBD (by NLM)
1. American College of Cardiology/American Heart Association Lesion Complexity Score C PROCESS_OF Cohort
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score C
Predicate
PROCESS_OF
Object
Cohort
2. risk factors PROCESS_OF Cohort
Subject
risk factors
Predicate
PROCESS_OF
Object
Cohort
3. Coronary Arteriosclerosis PROCESS_OF Recipient
Subject
Coronary Arteriosclerosis
Predicate
PROCESS_OF
Object
Recipient
4. hypertensive nephropathy PROCESS_OF Recipient
Subject
hypertensive nephropathy
Predicate
PROCESS_OF
Object
Recipient
5. Low BMI PROCESS_OF Recipient
Subject
Low BMI
Predicate
PROCESS_OF
Object
Recipient
6. American College of Cardiology/American Heart Association Lesion Complexity Score C PROCESS_OF Cohort
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score C
Predicate
PROCESS_OF
Object
Cohort
7. risk factors PROCESS_OF Cohort
Subject
risk factors
Predicate
PROCESS_OF
Object
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8. Coronary Arteriosclerosis PROCESS_OF Recipient
Subject
Coronary Arteriosclerosis
Predicate
PROCESS_OF
Object
Recipient
9. hypertensive nephropathy PROCESS_OF Recipient
Subject
hypertensive nephropathy
Predicate
PROCESS_OF
Object
Recipient
10. Low BMI PROCESS_OF Recipient
Subject
Low BMI
Predicate
PROCESS_OF
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Recipient
ABSTRACT
Health care systems worldwide have been facing major challenges since the outbreak of the SARS-CoV-2 pandemic. Kidney transplantation (KT) has been tremendously affected due to limited personal protective equipment (PPE) and intensive care unit (ICU) capacities. To provide valid information on risk factors for ICU admission in a high-risk cohort of old kidney recipients from old donors in the Eurotransplant Senior Program (ESP), we retrospectively conducted a bi-centric analysis. Overall, 17 (16.2%) patients out of 105 KTs were admitted to the ICU. They had a lower BMI, and both coronary artery disease (CAD) and hypertensive nephropathy were more frequent. A risk model combining BMI, CAD and hypertensive nephropathy gained a sensitivity of 94.1% and a negative predictive value of 97.8%, rendering it a valuable search test, but with low specificity (51.1%). ICU admission also proved to be an excellent parameter identifying patients at risk for short patient and graft survivals. Patients admitted to the ICU had shorter patient (1-year 57% vs. 90%) and graft (5-year 49% vs. 77%) survival. To conclude, potential kidney recipients with a low BMI, CAD and hypertensive nephropathy should only be transplanted in the ESP in times of SARS-CoV-2 pandemic if the local health situation can provide sufficient ICU capacities.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Etiology study / Prognostic study / Risk factors Language: English Year: 2020 Document Type: Article Affiliation country: Jcm9061835

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Etiology study / Prognostic study / Risk factors Language: English Year: 2020 Document Type: Article Affiliation country: Jcm9061835