Is it Safe to Be Transplanted From Living Donors Who Recovered From COVID-19? Experience of 31 Kidney Transplants in a Multicenter Cohort Study From India

Kute, Vivek B.; Godara, Suraj; Guleria, Sandeep; Ray, Deepak S.; Aziz, Feroz; Hegde, Umapati; Sharma, Ashish; Nayak, K.S.; Siddini, Vishwanath; Sarkar, Piyali; Thukral, Sharmila; Mondal, Rabi Ranjan Sow; Goswami, Jitendra; Patel, Himanshu V.; Abraham M., Abi; Pathak, Vivek; Anandh, Urmila; Jha, Pranaw Kumar; Bavikar, Suhas; Bonu, Ravi Shankar; Gulati, Sanjeev; B.T., Anil Kumar; Yadav, Dinesh Kumar

BACKGROUND. There is lack of data on feasibility and safety of kidney transplants from living donors who recovered from COVID-19. METHODS. Here, we present a retrospective cohort study of 31 kidney transplant recipients (KTR) from living donors who recovered from polymerase chain reaction confirmed COVID-19 across 19 transplant centers in India from July 3, 2020, to December 5, 2020. We detailed demographics, clinical manifestations, immunosuppression regimen, treatment, and outcomes. Donors with a previous diagnosis of COVID-19 were accepted after documenting 2 negative polymerase chain reaction tests with complete symptom resolution for at least 28 days and significant social distancing for 14 days before surgery. RESULTS. COVID-19 clinical severity in donors ranged from completely asymptomatic (71%, n = 22) to mild infection (29%, n = 9). None progressed to moderate or severe stages of the disease in the entire clinical course of home treatment. Patient and graft survival was 100%, respectively, with acute cellular rejection being reported in 6.4% (n = 2) recipient. All recipients and donors were asymptomatic with normal creatinine at median follow-up of 44 days after surgery without any complications relating to surgery and COVID-19. CONCLUSIONS. Our data support safety of proceeding with living donation for asymptomatic individuals with comprehensive donor, recipients screening before surgery, using a combination of clinical, radiologic, and laboratory criteria. It could provide new insights into the management of KTR from living donors who have recovered from COVID-19 in India. To the best of our knowledge, this remains the largest cohort of KTR from living donors who recovered from COVID-19.