Outcomes of kidney transplantation in recipients with SARS-cov-2 infection: a 282-case single-center experience in Japan.

IF 2.2 4区 医学 Q2 UROLOGY & NEPHROLOGY Clinical and Experimental Nephrology Pub Date : 2024-10-03 DOI:10.1007/s10157-024-02560-0
Eri Sekido, Kohei Unagami, Kazuya Omoto, Ken Arimura, Ikumi Moriyama, Taro Banno, Ayaka Saitoh, Rikako Oki, Daigo Okada, Takafumi Yagisawa, Taichi Kanzawa, Kumiko Kitajima, Toshihito Hirai, Tomokazu Shimizu, Shigeyoshi Yamanaga, Hiroto Egawa, Masashi Inui, Junichi Hoshino, Hideki Ishida, Toshio Takagi
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Abstract

Background: The coronavirus disease 2019, caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has become a global epidemic. There are concerns regarding the severity of SARS-CoV-2 infections in kidney transplant (KTx) recipients. However, there is limited data on how the epidemic has affected the treatment and prognosis of these patients. Therefore, we aimed to report the changes in the treatment and outcomes of KTx recipients infected with SARS-CoV-2 during each wave at our institution.

Methods: A total of 282 KTx recipients who were infected with SARS-CoV-2 during the study period were followed up at Tokyo Women's Medical University between March 2020 and August 2022. We investigated the outcomes and treatments of infected KTx recipients.

Results: Nineteen (6.7%) patients showed severe outcomes, including eight SARS-CoV-2 infection-related deaths. Risk factors associated with severe outcomes included underlying conditions, such as diabetes mellitus, heart disease, and liver disease (odds ratios, 2.09, 2.88, and 5.52, respectively). Treatment strategies changed throughout the epidemic in response to changes in the SARS-CoV-2 variants. Antiviral drugs were gradually administered as soon as they were approved for use.

Conclusions: Treatment strategies for KTx recipients were gradually established over the course of the epidemic. Although the proportion of infected KTx recipients decreased compared to that of the general population throughout the epidemic, many patients still followed a severe course.

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感染 SARS-cov-2 的受者接受肾移植的结果:日本 282 例单中心经验。
背景:由严重急性呼吸系统综合征-冠状病毒 2(SARS-CoV-2)引起的冠状病毒病 2019 年已成为全球流行病。人们对肾移植(KTx)受者感染 SARS-CoV-2 的严重性表示担忧。然而,关于疫情如何影响这些患者的治疗和预后的数据却很有限。因此,我们旨在报告我院每一次疫潮中感染 SARS-CoV-2 的 KTx 受体的治疗和预后变化情况:方法:2020 年 3 月至 2022 年 8 月期间,东京女子医科大学对研究期间感染 SARS-CoV-2 的 282 名 KTx 接受者进行了随访。我们调查了受感染 KTx 患者的治疗结果:结果:19 名(6.7%)患者出现严重后果,其中 8 人因感染 SARS-CoV-2 而死亡。与严重后果相关的风险因素包括糖尿病、心脏病和肝病等基础疾病(几率比分别为 2.09、2.88 和 5.52)。在整个疫情期间,治疗策略随着 SARS-CoV-2 变体的变化而改变。抗病毒药物一经批准使用,就开始逐步使用:结论:针对 KTx 受体的治疗策略是在疫情期间逐步确立的。尽管在整个疫情期间,受 KTx 感染者的比例与普通人群相比有所下降,但仍有许多患者病情严重。
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来源期刊
Clinical and Experimental Nephrology
Clinical and Experimental Nephrology UROLOGY & NEPHROLOGY-
CiteScore
4.10
自引率
4.30%
发文量
135
审稿时长
4-8 weeks
期刊介绍: Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.
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