TRANSPLANTATION: Severity of COVID-19 among SOT (solid organ transplant) recipients (Sep. 2020).
TRANSPLANTATION: Severity of COVID-19 among SOT (solid organ transplant) recipients (Sep. 2020).
Solid-organ
transplant (SOT) recipients are currently
and permanently immunosuppressed, so, they may be at a higher risk for
severe coronavirus disease 2019 (COVID-19)
when they compared to the general population. In 2 large observational studies
of SOT recipients
with COVID-19, almost 80 to 90 % of ptns have
required hospitalization; of those,
nearly 40 % required
intensive care admission and about 30 % required mechanical
ventilation. At one month, the MR (mortality rate) was more than 20 %. While
these findings suggest that SOT recipients are at a higher
risk for poor outcome,
multivariate analyses in both reports observed that both age & chronic co-morbidities were the primary drivers of mortality rather than immunosuppression itself.
Re-transplantation after BK polyomavirus-associated nephropathy (July 2020)
BK
polyomavirus-associated nephropathy (BKPyVAN) is a crucial cause of allograft
loss after kidney transplant. Previous graft
loss due to BKPyVAN cannot be considered a
contraindication to re-transplant, but the available data on clinical outcome are
currently limited. In a case-control study that compared approximately 350 re-transplant
ptns with a history of BKPyVAN-induced
graft loss with more than 13,000 ptns
with a past history of graft loss due to other causes, there were
no differences in the rate
of 5-y allograft survival, acute rejection, or one-y ptn survival after commencing
re-transplantation. These observation may suggest that re-transplantation
after graft loss due to BKPyVAN
is globally associated with good outcome.
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