ArticleClinical transplantation2021
Immunosuppression practices during the COVID-19 pandemic: A multinational survey study of transplant programs.
Article in Clinical transplantation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Disparities in COVID-19 mortality amongst the immunosuppressed: A systematic review and meta-analysis for enhanced disease surveillance.The Journal of infection · 2024Pooled it
- COVID-19 and solid organ transplantation: Finding the right balance.Transplantation reviews (Orlando, Fla.) · 2022Pooled it
- Lessons learned: management of acute kidney injury during COVID-19.Renal failure · 2026Article
- Inferior outcomes of liver transplantation for hepatocellular carcinoma during early-COVID-19 pandemic in the United States.World journal of hepatology · 2023Article
- [Update of the recommendations on the management of the SARS-CoV-2 coronavirus pandemic (COVID-19) in kidney transplant patients.]Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia · 2022Review
- [Management of immunosuppressive therapy in kidney transplant recipients with COVID19. A multicentre national study derived form the S.E.N. COVID registry.]Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia · 2022Article
- Immunosuppression practices during the COVID-19 pandemic: A multinational survey study of transplant programs.Clinical transplantation · 2021Article
- Use of Organs from SARS-CoV-2 Infected Donors: Is It Safe? A Contemporary Review.Current transplantation reports · 2021Review
- Inferior Liver Transplant Outcomes during early COVID-19 pandemic in United States.Journal of liver transplantationArticle
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
During the COVID-19 pandemic, there has been wide heterogeneity in the medical management of transplant recipients. We aimed to pragmatically capture immunosuppression practices globally following the early months of the pandemic. From June to September 2020, we surveyed 1267 physicians; 40.5% from 71 countries participated. Management decisions were made on a case-by-case basis by the majority (69.6%) of the programs. Overall, 76.8% performed ≥1 transplantation and many commented on avoiding high-risk transplantations. For induction, 26.5% were less likely to give T-cell depletion and 14.8% were more likely to give non-depleting agents. These practices varied by program-level factors more so than the COVID-19 burden. In patients with mild, moderate and severe COVID-19 symptoms 59.7%, 76.0%, and 79.5% decreased/stopped anti-metabolites, 23.2%, 45.4%, and 68.2% decreased/stopped calcineurin inhibitors, and 25.7%, 43.9%, and 57.7% decreased/stopped mTOR inhibitors, respectively. Also, 2.1%, 30.6%, and 46.0% increased steroids in patients with mild, moderate, and severe COVID-19 symptoms. For prevalent transplant recipients, some programs also reported decreasing/stopping steroids (1.8%), anti-metabolites (10.3%), calcineurin inhibitors (4.1%), and mTOR inhibitors (5.5%). Transplant programs changed immunosuppression practices but also avoided high-risk transplants and increased maintenance steroids. The long-term ramifications of these practices remain to be seen as programs face the aftermath of the pandemic.
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