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4 . 2021

The course of the novel coronavirus infection COVID-19 in recipients of solid organs, depending on the type of maintenance immunosuppression according to the local transplant register

Abstract

Background. The novel coronavirus infection COVID-19 has had a significant impact on organ transplantation in the world, both by reducing the availability of deceased donor organs due to the overload of intensive care units with patients with viral pneumonia, and due to the severe course of infection in patients after transplantation secondary to maintenance immunosuppression. The composition of maintenance immunosuppression in a patient after transplantation may affect the course of coronavirus infection.

Study purpose. Based on the local transplant Register analysis, determine the effect of the composition of maintenance immunosuppression on the outcome of COVID-19 in organ transplant recipients.

Material and methods. In March 2020, due to the COVID-19 pandemic, additional blocks characterizing the COVID-19 in a patient were introduced into the modules of the Register. The analytical section of the Register allows to compare the results of transplantation in patients' groups arbitrarily formed by the researcher. Daily updating of data allows to analyze actual information. An analysis of COVID-19 outcomes in recipients of donor organs is carried out depending on the composition of maintenance immunosuppression.

Results. Between February 2020 and April 2021, the Register identified 72 recipients with COVID-19, of them 41 were on steroid-free immunosuppression. Recovered 93% of steroid-free patients and 48% of steroid based patients, mortality rate was 5 vs 42%, graft loss was 2 vs 10%.

Conclusion. The Transplant Register, which exists in the legal field of Russian legislation, taking into account information about transplants performed in specific medical centers to specific patients, their effectiveness, including the practice of their rehabilitation and medical support, allows timely identification of successful practices, including in new conditions arising in connection with the COVID-19 pandemic.

Maintenance immunosuppression without steroids significantly increase the chances of a favorable outcome of COVID-19 in organ transplant recipients.

Keywords:liver transplantation, pancreas transplantation, graft survival, patient survival, transplantation registry, COVID-19, SARS-CoV-2, steroids, steroid-free immunosuppression

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Kaabak M.M., Rappoport N.N. The course of the novel coronavirus infection COVID-19 in recipients of solid organs, depending on the type of maintenance immunosuppression according to the local transplant register. Clinical and Experimental Surgery. Petrovsky Journal. 2021; 9 (4): 12-9. DOI: https://doi.org/10.33029/2308-1198-2021-9-4-12-19 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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