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Revista Colombiana de Nefrología
On-line version ISSN 2500-5006
Abstract
TORRES SERRANO, Rodolfo et al. Recommendations of the Colombian Association of Nephrology in renal transplantation during the coronavirus pandemic (COVID-19). Rev. colom. nefrol. [online]. 2020, vol.7, suppl.2, pp.70-88. Epub May 08, 2021. ISSN 2500-5006. https://doi.org/10.22265/acnef.7.supl.2.447.
Introduction:
Kidney transplant patients are a high-risk population for complications and mortality associated with SARS CoV2 infection. Different reports in the literature have shown a higher frequency of respiratory compromise and mortality, currently don’t exist recommendations with an adequate level of evidence regarding the management of base immunosuppression and treatment strategies in this population, for which reason it is necessary from the national scene, build recommendations based on the available evidence and consensus of experts, to be applied at the local level.
Objective:
To develop, by means of an expert consensus and a review of the available literature, recommendations for the prevention, diagnosis and management of transplant patients with SARS Cov2 infection. And give recommendations to continue with the organ procurement and transplant activity in the scenario of the COVID-19 pandemic.
Materials and methods:
Questions were asked about SARS Cov2 infection in kidney transplantation, with emphasis on clinical behavior, frequency of infection, prevention, diagnosis, management of immunosuppression and treatment. A search of the literature in Pubmed, Embase and scientific societies was performed to answer each of the questions. The discussion of the answers to each of the questions according to the available evidence and the possibility of adapting them to local practice was carried out by consensus method and panel of experts. Nephrology and transplant surgery specialists from transplant groups in the country participated in the consensus.
Results:
A panel of experts was held to discuss the questions and answers found in the literature between April 23, 2020 and May 10, 2020, for each question a panel discussion was held where the total of experts discussed and Evaluates the quality of the evidence to issue a final recommendation on each evaluated point. A consolidation of the main series of cases of SARS-CoV2 infection in the kidney transplant population and the clinical outcomes was carried out up to the moment of publication.
Conclusions:
According to what is found in the literature, recommendations are made for the prevention, diagnosis and management of patients with kidney transplantation and SARS-CoV2 infection, emphasizing behavior with respect to basic immunosuppressive management, and highlighting the importance of the pharmacological interactions of the available treatments for SARS-CoV2 with immunosuppressive therapy, recommendations are also given to implement the procupara and transplant activity safely during the pandemic.
Keywords : COVID-19; SARS-Cov 2; coronavirus; betacoronavirus; kidney transplantation; renal transplantation; kidney grafting (MeSH).