Navigating Kidney Transplantation in the Early Phase of COVID-19: Screening Patients with RT-PCR and Low Radiation Dose Chest CT

Butt, Fauzia K.; Julian, Kathleen; Kadry, Zakiyah; Jain, Ashokkumar

Background The COVID-19 viral pandemic of 2020 changed organ transplantation. All elective cases at our institution were postponed for approximately 3 months. CMS considers organ transplant surgery a Tier 3b case, along with other high acuity procedures, recommending no postponement. Our transplant program collaborated with our transplant infectious disease colleagues to create a protocol that would ensure both patient and staff safety during these unprecedented times Methods The living donor program was electively placed on hold until we had the proper protocols in place. Pre-operative COVID-19 testing was required for all recipients and living donors. All patients underwent a rapid nasopharyngeal (NP) swab test. After testing negative by NP swab, recipients also underwent a low radiation dose CT scan to rule out any radiographic changes suggestive of a COVID-19 infection Results We performed 8 living donor and 9 deceased donor kidney transplants. In comparison, we performed 10 living donor and 4 deceased donor transplants during the same time period in the previous year. Our testing protocol enabled efficient utilization of all suitable organs offered during the viral pandemic. No recipients or living donors tested positive or developed COVID-19 Conclusions Creation of a viral testing protocol, developed in conjunction with our infectious disease team, permitted kidney transplantation to be performed safely and the number of deceased donor transplants increased considerably, without adversely affecting our outcomes.