Should We Perform Old-for-Old Kidney Transplantation during the COVID-19 Pandemic? The Risk for Post-Operative Intensive Stay
Health care systems worldwide have been facing major challenges since the outbreak of the SARS-CoV-2 pandemic. Kidney transplantation (KT) has been tremendously affected due to limited personal protective equipment (PPE) and intensive care unit (ICU) capacities. To provide valid information on risk...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-06-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/9/6/1835 |
| id |
doaj-2ac38c4f046e47dbb33be799f2f46212 |
|---|---|
| record_format |
Article |
| collection |
DOAJ |
| language |
English |
| format |
Article |
| sources |
DOAJ |
| author |
Philip Zeuschner Urban Sester Michael Stöckle Matthias Saar Ilias Zompolas Nasrin El‑Bandar Lutz Liefeldt Klemens Budde Robert Öllinger Paul Ritschl Thorsten Schlomm Janine Mihm Frank Friedersdorff |
| spellingShingle |
Philip Zeuschner Urban Sester Michael Stöckle Matthias Saar Ilias Zompolas Nasrin El‑Bandar Lutz Liefeldt Klemens Budde Robert Öllinger Paul Ritschl Thorsten Schlomm Janine Mihm Frank Friedersdorff Should We Perform Old-for-Old Kidney Transplantation during the COVID-19 Pandemic? The Risk for Post-Operative Intensive Stay Journal of Clinical Medicine kidney transplantation organ donation deceased donor Eurotransplant Senior Program risk stratification intensive care |
| author_facet |
Philip Zeuschner Urban Sester Michael Stöckle Matthias Saar Ilias Zompolas Nasrin El‑Bandar Lutz Liefeldt Klemens Budde Robert Öllinger Paul Ritschl Thorsten Schlomm Janine Mihm Frank Friedersdorff |
| author_sort |
Philip Zeuschner |
| title |
Should We Perform Old-for-Old Kidney Transplantation during the COVID-19 Pandemic? The Risk for Post-Operative Intensive Stay |
| title_short |
Should We Perform Old-for-Old Kidney Transplantation during the COVID-19 Pandemic? The Risk for Post-Operative Intensive Stay |
| title_full |
Should We Perform Old-for-Old Kidney Transplantation during the COVID-19 Pandemic? The Risk for Post-Operative Intensive Stay |
| title_fullStr |
Should We Perform Old-for-Old Kidney Transplantation during the COVID-19 Pandemic? The Risk for Post-Operative Intensive Stay |
| title_full_unstemmed |
Should We Perform Old-for-Old Kidney Transplantation during the COVID-19 Pandemic? The Risk for Post-Operative Intensive Stay |
| title_sort |
should we perform old-for-old kidney transplantation during the covid-19 pandemic? the risk for post-operative intensive stay |
| publisher |
MDPI AG |
| series |
Journal of Clinical Medicine |
| issn |
2077-0383 |
| publishDate |
2020-06-01 |
| description |
Health care systems worldwide have been facing major challenges since the outbreak of the SARS-CoV-2 pandemic. Kidney transplantation (KT) has been tremendously affected due to limited personal protective equipment (PPE) and intensive care unit (ICU) capacities. To provide valid information on risk factors for ICU admission in a high-risk cohort of old kidney recipients from old donors in the Eurotransplant Senior Program (ESP), we retrospectively conducted a bi-centric analysis. Overall, 17 (16.2%) patients out of 105 KTs were admitted to the ICU. They had a lower BMI, and both coronary artery disease (CAD) and hypertensive nephropathy were more frequent. A risk model combining BMI, CAD and hypertensive nephropathy gained a sensitivity of 94.1% and a negative predictive value of 97.8%, rendering it a valuable search test, but with low specificity (51.1%). ICU admission also proved to be an excellent parameter identifying patients at risk for short patient and graft survivals. Patients admitted to the ICU had shorter patient (1-year 57% vs. 90%) and graft (5-year 49% vs. 77%) survival. To conclude, potential kidney recipients with a low BMI, CAD and hypertensive nephropathy should only be transplanted in the ESP in times of SARS-CoV-2 pandemic if the local health situation can provide sufficient ICU capacities. |
| topic |
kidney transplantation organ donation deceased donor Eurotransplant Senior Program risk stratification intensive care |
| url |
https://www.mdpi.com/2077-0383/9/6/1835 |
| work_keys_str_mv |
AT philipzeuschner shouldweperformoldforoldkidneytransplantationduringthecovid19pandemictheriskforpostoperativeintensivestay AT urbansester shouldweperformoldforoldkidneytransplantationduringthecovid19pandemictheriskforpostoperativeintensivestay AT michaelstockle shouldweperformoldforoldkidneytransplantationduringthecovid19pandemictheriskforpostoperativeintensivestay AT matthiassaar shouldweperformoldforoldkidneytransplantationduringthecovid19pandemictheriskforpostoperativeintensivestay AT iliaszompolas shouldweperformoldforoldkidneytransplantationduringthecovid19pandemictheriskforpostoperativeintensivestay AT nasrinelbandar shouldweperformoldforoldkidneytransplantationduringthecovid19pandemictheriskforpostoperativeintensivestay AT lutzliefeldt shouldweperformoldforoldkidneytransplantationduringthecovid19pandemictheriskforpostoperativeintensivestay AT klemensbudde shouldweperformoldforoldkidneytransplantationduringthecovid19pandemictheriskforpostoperativeintensivestay AT robertollinger shouldweperformoldforoldkidneytransplantationduringthecovid19pandemictheriskforpostoperativeintensivestay AT paulritschl shouldweperformoldforoldkidneytransplantationduringthecovid19pandemictheriskforpostoperativeintensivestay AT thorstenschlomm shouldweperformoldforoldkidneytransplantationduringthecovid19pandemictheriskforpostoperativeintensivestay AT janinemihm shouldweperformoldforoldkidneytransplantationduringthecovid19pandemictheriskforpostoperativeintensivestay AT frankfriedersdorff shouldweperformoldforoldkidneytransplantationduringthecovid19pandemictheriskforpostoperativeintensivestay |
| _version_ |
1724455947621892096 |
| spelling |
doaj-2ac38c4f046e47dbb33be799f2f462122020-11-25T03:59:01ZengMDPI AGJournal of Clinical Medicine2077-03832020-06-0191835183510.3390/jcm9061835Should We Perform Old-for-Old Kidney Transplantation during the COVID-19 Pandemic? The Risk for Post-Operative Intensive StayPhilip Zeuschner0Urban Sester1Michael Stöckle2Matthias Saar3Ilias Zompolas4Nasrin El‑Bandar5Lutz Liefeldt6Klemens Budde7Robert Öllinger8Paul Ritschl9Thorsten Schlomm10Janine Mihm11Frank Friedersdorff12Department of Urology and Pediatric Urology, Saarland University, Kirrberger Street 100, 66421 Homburg/Saar, GermanyDepartment of Nephrology and Hypertension, Internal Medicine IV, Saarland University, Kirrberger Street 100, 66421 Homburg/Saar, GermanyDepartment of Urology and Pediatric Urology, Saarland University, Kirrberger Street 100, 66421 Homburg/Saar, GermanyDepartment of Urology and Pediatric Urology, Saarland University, Kirrberger Street 100, 66421 Homburg/Saar, GermanyDepartment of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, GermanyDepartment of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, GermanyDepartment of Nephrology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, GermanyDepartment of Nephrology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, GermanyDepartment of Surgery, Campus Charité Mitte/Campus Virchow-Klinikum CCM/CVK, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, GermanyDepartment of Surgery, Campus Charité Mitte/Campus Virchow-Klinikum CCM/CVK, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, GermanyDepartment of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, GermanyDepartment of Nephrology and Hypertension, Internal Medicine IV, Saarland University, Kirrberger Street 100, 66421 Homburg/Saar, GermanyDepartment of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, GermanyHealth care systems worldwide have been facing major challenges since the outbreak of the SARS-CoV-2 pandemic. Kidney transplantation (KT) has been tremendously affected due to limited personal protective equipment (PPE) and intensive care unit (ICU) capacities. To provide valid information on risk factors for ICU admission in a high-risk cohort of old kidney recipients from old donors in the Eurotransplant Senior Program (ESP), we retrospectively conducted a bi-centric analysis. Overall, 17 (16.2%) patients out of 105 KTs were admitted to the ICU. They had a lower BMI, and both coronary artery disease (CAD) and hypertensive nephropathy were more frequent. A risk model combining BMI, CAD and hypertensive nephropathy gained a sensitivity of 94.1% and a negative predictive value of 97.8%, rendering it a valuable search test, but with low specificity (51.1%). ICU admission also proved to be an excellent parameter identifying patients at risk for short patient and graft survivals. Patients admitted to the ICU had shorter patient (1-year 57% vs. 90%) and graft (5-year 49% vs. 77%) survival. To conclude, potential kidney recipients with a low BMI, CAD and hypertensive nephropathy should only be transplanted in the ESP in times of SARS-CoV-2 pandemic if the local health situation can provide sufficient ICU capacities.https://www.mdpi.com/2077-0383/9/6/1835kidney transplantationorgan donationdeceased donorEurotransplant Senior Programrisk stratificationintensive care |