EFFECTS OF COVID 19 ON SOLID ORGAN TRANSPLANTATION

Aziz, Hassan; Lashkari, Nassim; Yoon, Young Chul; Kim, Jim; Sher, Linda S.; Genyk, Yuri; Kwon, Yong K.

Background As the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a viral pandemic, data on the clinical characteristics and outcomes of patients with SARS-CoV-2 infection undergoing solid organ transplant is emerging. The objective of this systematic review is to assess currently published literature relating to the management, clinical course and outcomes of SARS-Cov-2 infection in liver, kidney and heart SOT recipients. Methods We conducted a systematic review to assess currently published literature relating to the management, clinical course and outcomes of SARS-CoV-2 infection in liver, kidney and heart solid organ transplant recipients. Articles published as of June 2020 were searched in the MEDLINE, ClinicalTrials.gov and PubMed databases. We identified 49 eligible studies with a total of 403 solid organ transplant recipients. Results Older age, male sex and pre-existing comorbidity including hypertension and/or diabetes were the most common prevailing characteristics amongst the solid organ transplant recipients. Clinical presentation ranged from mild to severe disease including multi-organ failure and death. We reported an overall mortality of 21%. Conclusions Our analysis suggests no increase in overall mortality or worse outcome in solid organ transplant recipients on immunosuppressive therapy compared with mortality in the general surgical population with SARS-CoV-2. Our findings suggest that transplant surgery and its immunosuppression effects should not be a deterrence to proper surgical care for patients in the SARS-CoV-2 era.