scholarly journals 1336. Outcomes of COVID-19 in Recent Kidney Transplants Recipients at a Large Transplant Center in Miami

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S756-S756
Author(s):  
Maria A Mendoza ◽  
Ana Coro ◽  
Yoichiro Natori ◽  
Shweta Anjan ◽  
Giselle Guerra ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Graft Function ◽  
Deceased Donor ◽  
Lower Survival Rate ◽  
Transplant Patients ◽  
Deceased Donor Kidney ◽  
Transplant Center ◽  
Polymerase Chain ◽  
Deceased Donor Kidney Transplant

Abstract Background Outcomes of COVID-19 have been reported in deceased donor kidney transplant (DDKT) recipients. However, data is limited in patients that underwent recent DDKT. Methods This single-center retrospective study evaluated the differences in demographics and post-transplant outcomes between those who tested positive and negative for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by polymerase chain reaction, after undergoing recent DDKT. The treatments and outcomes for the SARS-CoV-2-positive patients were assessed. Patients who underwent DDKT from 3/2020 to 8/2020 were included and followed until 9/2020. Results 201 DDKT recipients were analyzed [14(7%) SARS-CoV-2-positive and 187(93%) negative]. There was no difference in delayed graft function and biopsy-proven rejection between both groups. The patient survival at the end of the study follow-up was lower among SARS-CoV-2-positive patients (Table 1). The median time from DDKT to COVID-19 diagnosis was 45 (range: 8-90) days; 5(36%) patients required intensive care unit and 4(29%) required mechanical ventilation; steroids were used in all the patients, therapeutic plasma exchange (TPE) and convalescent plasma (CP) in 7(50%) patients each, remdesivir in 6(43%) and tocilizumab in 1(7%); 9(64%) patients recovered, 3(21%) died and two were still requiring mechanical ventilation at the end of the follow-up. Conclusion Our cohort demonstrated a lower survival rate among SARS-CoV-2-positive patients, which highlights the vulnerability of the transplant population. Transplant patients must comply with the CDC recommendations to prevent COVID-19. Disclosures All Authors: No reported disclosures

Does Distance to Transplant Center Affect Post Kidney Transplant Readmission Rates?

2019 ◽  
Vol 85 (8) ◽  
pp. 834-839
Author(s):  
Jessica Schucht ◽  
Eric G. Davis ◽  
Christopher M. Jones ◽  
Robert M. Cannon
Keyword(s):  
Kidney Transplant ◽  
Graft Survival ◽  
Rural Areas ◽  
Graft Function ◽  
Retrospective Chart Review ◽  
Deceased Donor ◽  
Readmission Rates ◽  
Deceased Donor Kidney ◽  
Transplant Center ◽  
Deceased Donor Kidney Transplant

Many transplant recipients travel long distances to their transplant center with challenging access to their transplant team. As such, many centers keep recipients near to the center for a period immediately after discharge from the transplant admission. Thus far, the correlation between distance to the transplant center, readmission, and outcomes has not been described. The aim of this study was to examine this relationship. Patients undergoing deceased donor kidney transplant at a single center over a three-year period were analyzed via retrospective chart review for factors associated with distance to the transplant center and readmission. P values < 0.05 were considered significant. Of 141 patients, the overall 90-day readmission rate was 38.3 per cent, and rates were similar between nonlocal and local recipients. Nonlocal were more likely whites (66.1% vs 45.6%; P = 0.032) and from rural areas (56.5% vs 13.9%; P < 0.001). Length of stay was similar between groups, as were rates of delayed graft function. Non–death-censored graft survival was higher at one and three years for nonlocal patients (96.8% and 96.8% vs 89.7% and 78.4%; P = 0.016). This remained significant after adjusting for baseline differences between the groups (hazard ratio (HR) for graft failure = 0.195, 95%, P = 0.046). Patients who live remotely from the transplant center do not experience higher rates of readmission or worsened outcomes, and thus may be managed safely at home. Interestingly, graft survival is improved in nonlocal patients. This may reflect the urban nature of the area surrounding our transplant center, but warrants further study for conclusions to be reached.

scholarly journals Results of Deceased Donor Kidney Transplantation in Young Recipients after Age-matched and Mismatched (Old-to-young) Transplantation

2016 ◽  
Vol 16 (2) ◽  
pp. 8-11
Author(s):  
Janis Jushinskis ◽  
Vadims Suhorukovs ◽  
Aleksandrs Malcevs ◽  
Ieva Ziedina ◽  
Rafails Rozentals
Keyword(s):  
Graft Function ◽  
Deceased Donor ◽  
Rejection Rate ◽  
Donor Age ◽  
Donor Kidney ◽  
Deceased Donor Kidney ◽  
Significant Difference ◽  
Deceased Donors ◽  
Kidney Transplantations

SummaryIntroduction.During the previous years the number of organ transplantations from elderly donors increased, and lack of young donors leads to necessity to allocate organs from elderly into young recipients.Aim of the Study.Was to analyse results of “old-to-young” allocation.Material and methods.This retrospective study analysed results of all consecutive deceased donor kidney transplantations (DDKT) performed in one transplant centre during the period from 01.01.2004 till 31.12.2007. Patients were selected based on availability of 5-year follow-up and age < 50 years (158 DDKT). Patients were divided into 2 groups according to donor age: age-mismatched group (donor age was > 55 years and at the same time > 15 years older than recipient; n=8, male/female=2/6, age 39,4 + 4,8 years, donor age 59,4 + 2,4 years), and age-matched group (n=150, male/female=88/62, age 36,0 + 11,0 years, donor age 37,3 + 12,0 years). Groups were compared for clinical and demographical features and posttransplant outcomes (delayed graft function, s-creatinin levels at discharge and after 5 years, acute rejection rate, graft and patient 5-year survival).Results.Comparison of demographical and clinical features revealed only relatively higher BMI in elderly donors (p=0.081) and higher frequency of age-mismatched allocation into female recipients (p=0.066). Early and late post-transplant outcomes showed no significant difference between groups, with similar 5-year graft and patient survival (p=NS for all compared factors).Conclusion.Results showed good kidney allograft function even in cases of age-mismatched allocation, which is significant opportunity in current situation with increasing age of deceased donors.

P1728FUROSEMIDE STRESS TEST PREDICTS DISCHARGE SERUM CREATININE AFTER KIDNEY TRANSPLANTATION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Armando Coca ◽  
Guadalupe Tabernero ◽  
Carlos Arias-Cabrales ◽  
Jimmy Reinaldo Sanchez Gil ◽  
Jose Antonio Menacho Miguel ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Serum Creatinine ◽  
Stress Test ◽  
Graft Function ◽  
Deceased Donor ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Donor Kidney ◽  
Deceased Donor Kidney ◽  
Deceased Donor Kidney Transplant

Abstract Background and Aims Acute tubular necrosis is a common complication after kidney transplantation and is closely related to delayed graft function (DGF) and slower graft function recovery after surgery. The furosemide stress test (FST) uses a standardized dose of furosemide to evaluate the integrity of the renal tubule and determine which patients have developed severe tubular damage. We aimed to apply the FST to a sample of incident deceased-donor kidney transplant recipients and describe its association with DGF and serum creatinine (SCr) at discharge. Method Single-center prospective observational study of deceased-donor kidney transplant recipients. The FST, a standardized bolus dose of furosemide (1.5 mg/kg) was administered between the 3rd and 5th day after surgery. Patients were excluded if, during that time period, they presented evidence of active bleeding, obstructive uropathy or volume depletion. Urine output (UO) 60 and 120 min after FST was registered. To reduce the risk of hypovolemia, each ml of UO produced for six hours after FST was replaced with 1 ml of normal saline. Results 25 patients were included in the study. Mean 2h FST UO was 1012±570 ml. Demographic and clinical data are summarized in Table 1. Subjects that suffered DGF had a significantly lower 2h FST UO (534 vs 1164 ml; P=0.015). In adjusted linear regression analysis only a 2h FST UO&lt;1000 ml (β=0.906; 95%CI: 0.04-1.772; P=0.041) and DGF (β=1.592; 95%CI: 0.488-2.696; P=0.008) were independent predictors of SCr at discharge (model adjusted for recipient age, cold ischemia time, number of HLA mismatches, donor SCr and donor hypertension). Conclusion Recipients with a 2h FST UO &lt;1000 ml suffered DGF more frequently. FST and DGF were independent predictors of SCr at discharge. A standardized FST could help clinicians distinguish patients with more severe tubular dysfunction and higher risk of DGF.

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