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Solid Organ Transplantation in the Era of COVID-19: Lessons from France.
Zaidan, Mohamad; Legendre, Christophe.
  • Zaidan M; Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin-Bicêtre, France.
  • Legendre C; Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France.
Transplantation ; 105(1): 61-66, 2021 01 01.
Article in English | MEDLINE | ID: covidwho-991010
ABSTRACT
Coronavirus disease 2019 (COVID-19) outbreak has significantly upended solid organ transplant (SOT) practice around the world. Early reports confirmed the heavy burden of COVID-19 in SOT recipients with mortality rates reaching up to 35%. Because most transplant recipients harbored multiple comorbidities known to be associated with a severe course of COVID-19, the true impact of immunosuppression by itself remained an unsolved issue. Transplant societies have initially recommended to postpone nonurgent renal transplantations, while trying to maintain life-saving transplant programs, such as heart, lung, and liver transplantations. The pandemic thus resulted in an unprecedented and sudden drop of transplant activity worldwide. Moreover, the best treatment strategy in infected patients was challenging. Both reduction of immunosuppression and use of targeted therapies aiming at counteracting severe acute respiratory syndrome coronavirus 2 infection were the 2 faces of the therapeutic armamentarium. Recent controlled studies have better delineated the basis of mitigating and management strategies to improve patients' outcome. Nevertheless, and given the persistence of circulating virus, evidence-based recommendations in SOT recipients remain unclear. The resumption of transplant activity should be tailored with careful selection of both donors and recipients. Transplant decision should be made on a case-by-case basis after thorough assessment of the risks and benefits.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Organ Transplantation / SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Humans Country/Region as subject: Europa Language: English Journal: Transplantation Year: 2021 Document Type: Article Affiliation country: TP.0000000000003536

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Organ Transplantation / SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Humans Country/Region as subject: Europa Language: English Journal: Transplantation Year: 2021 Document Type: Article Affiliation country: TP.0000000000003536