Poor Compliance Causes Acute Rejection in Kidney Transplant Recipients During COVID-19 Pandemic: 2 Cases Report.

The COVID-19 pandemic has lasted for more than one year, which caused much trouble to the health management of kidney transplant recipients. Numerous patients cancelled their review appointment or even lost connection with doctors because of the great pressure medical system undergoing, strict travel restrictions, and the worries about COVID-19 infection risk. Herein, we introduce two kidney transplant recipients, a 33-year-old man and a 32-year-old man, who did not take the immunosuppressant drugs and did not go back to the hospital to do the renal function examination as the doctor's request. When they paid their first return visit several months after the pandemic outbreak, they were both diagnosed with acute rejection and admitted to the hospital. After receiving pulse steroid therapy, they were in remission but failed to reverse the rejection. The level of serum creatinine did not recover to the one before pandemic outbreak. These cases suggest that it is necessary to ensure that kidney transplant recipients follow the doctor's advice to take drugs and follow-up regularly to examine their renal function over pandemic period. Additionally, typical pulse steroid therapy may not that effective toward these patients.