ArticleTransplantation2021
Early Changes in Kidney Transplant Immunosuppression Regimens During the COVID-19 Pandemic.
Article in Transplantation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 40 citations in OpenAlex.
- COVID-19 and renal allograft rejection: insight from controlled and non-controlled studies.Renal failure · 2024Review
- Impact of Cumulative 6 mg/kg Antithymocyte Globulin on Early Posttransplant Outcomes in Kidney Transplant Recipients with Delayed Graft Function.Progress in transplantation (Aliso Viejo, Calif.) · 2024Article
- The analysis of low-dose glucocorticoid maintenance therapy in patients with primary nephrotic syndrome suffering from COVID-19.Frontiers in molecular biosciences · 2023Article
- Impact of the COVID-19 Pandemic on Solid Organ Transplant and Rejection Episodes in Brazil's Unified Healthcare System.Journal of clinical medicine · 2022Article
- Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantation.Clinical kidney journal · 2022Article
- Impact of COVID 19 pandemic on patients requiring renal biopsy.International urology and nephrology · 2022Article
- Issues regarding COVID-19 in kidney transplantation in the ERA of the Omicron variant: a commentary by the ERA Descartes Working Group.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2022Article
- COVID-19 and corticosteroids: a narrative review.Inflammopharmacology · 2022Review
- Ethical Issues in Kidney Transplant and Donation During COVID-19 Pandemic.Seminars in nephrology · 2022Review
- The impact of COVID-19 on kidney transplant care.Frontiers in medicine · 2022Review
- Safety of Antithymocyte Globulin Use in Kidney Graft Recipients During the COVID-19 Pandemic.Annals of transplantation · 2021Article
- Is Early COVID-19 in Kidney Transplant Recipients Concerning Enough to Halt Transplantation? A Multicenter Comparative Analysis from India.Transplantation proceedings · 2021Article
- Clinical Practice Guideline for Solid Organ Donation and Transplantation During the COVID-19 Pandemic.Transplantation direct · 2021Article
- The Magnitude and Functionality of SARS-CoV-2 Reactive Cellular and Humoral Immunity in Transplant Population Is Similar to the General Population Despite Immunosuppression.Transplantation · 2021Article
- A case report of successful kidney transplantation from a deceased donor with terminal COVID-19-related lung damage: Ongoing dilemma between discarding and accepting organs in COVID-19 era!Transplant infectious disease : an official journal of the Transplantation Society · 2021Article
- Immunosuppression practices during the COVID-19 pandemic: A multinational survey study of transplant programs.Clinical transplantation · 2021Article
- Risks and Benefits of Kidney Transplantation during the COVID-19 Pandemic: Transplant or Not Transplant?Kidney360 · 2021Review
- Post-mortem molecular investigations of SARS-CoV-2 in an unexpected death of a recent kidney transplant recipient.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- COVID-19 in immunocompromised populations: implications for prognosis and repurposing of immunotherapies.Journal for immunotherapy of cancer · 2021Review
- Practicing With Uncertainty: Kidney Transplantation During the COVID-19 Pandemic.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2021Review
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9 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundKidney transplant recipients have higher risk of infectious diseases due to their reliance on immunosuppression. During the current COVID-19 pandemic, some clinicians might have opted for less potent immunosuppressive agents to counterbalance the novel infectious risk. We conducted a nationwide study to characterize immunosuppression use and subsequent clinical outcomes during the first 5 months of COVID-19 pandemic in the United States.
methodsUsing data from the Scientific Registry of Transplant Recipients, we studied all kidney-only recipients in the United States from January 1, 2017, to March 12, 2020 ("prepandemic" era; n = 64 849) and from March 13, 2020, to July 31, 2020 ("pandemic" era; n = 5035). We compared the use of lymphocyte-depleting agents (versus basiliximab or no induction) and maintenance steroids (versus steroid avoidance/withdrawal) in the pandemic era compared with the prepandemic era. Then, we compared early posttransplant outcomes by immunosuppression regimen during the pandemic era.
resultsRecipients in the pandemic era were substantially less likely to receive lymphocyte-depleting induction agents compared with their prepandemic counterparts (aOR = 0.400.530.69); similar trends were found across subgroups of state-level COVID-19 incidence, donor type, and recipient age. However, lymphocyte-depleting induction agents were associated with decreased rejection during admission (aOR = 0.110.230.47) but not with increased mortality in the pandemic era (aHR = 0.130.471.66). On the other hand, the use of maintenance steroids versus early steroid withdrawal remained similar (aOR = 0.711.071.62).
conclusionsThe use of lymphocyte-depleting induction agents has decreased in favor of basiliximab and no induction during the COVID-19 pandemic. However, this shift might have resulted in increases in rejection with no clear reductions in posttransplant mortality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.