Akademik Veri Yönetim Sistemi
21st Biennial European Society for Organ Transplantation (ESOT) Congress, Athens, Greece, 17 – 20 September 2023, Athens, Yunanistan, 17 - 20 Eylül 2023, ss.229
Background: After beginning of the Covid-19 pandemic due to initial reports
of high mortality in patients with multiple comorbidities, almost all transplant
centres develop different immunosuppressive protocols to decrease the
mortality rates in their chronic immunosuppressive kidney transplant patients.
In this study, we revealed the outcomes of our immunosuppressive protocols
during the different phases of the Covid-19 pandemic.
Methods: In the first phase of Covid-19 due to the high mortality risk of dominant variants until December 2021; the protocol was an increased dose of prednisolone (20mg/day) and complete cessation of calcineurin and MMF. When the
dominant variant became Omicron in the second phase, prednisolone 20mg/
day, 50% dose reduction of tacrolimus and MMF cessation were applied. The
data were evaluated retrospectively in terms of mortality, biopsy-proven rejection, allograft loss, and allograft functions.
Results: Of the 592 follow-up patients at our centre, 132 of them (13.2%) had
Covid-19 infection. In the first phase, infection developed in 108 patients (mean
age 47.07±12.9 years, 54.6% male, 49% one comorbidity, 9.3% three comorbidities). The mortality rate was 10.2%, Biopsy proven rejection was 3.7%, the
need for RRT was 1.9%, and allograft loss was 0.9%. Allograft functions of the
patients were well preserved (64ml/min vs. 67.4ml/min GFR, 312.3±766.2mg/
dl vs. 435.74±1302mg/dl proteinuria, p=NS). In the second phase of Covid-19
infection, 24 patients were infected (mean age 47±12.98 years, 45.8% male,
46% one comorbidity, 8.3% three comorbidities). Mortality was detected in one
patient (4.2%), while biopsy-proven rejection and temporary RRT were required
in one patient (4.2%), and allograft loss did not occur. Allograft functions of the
patients were well preserved (60ml/min vs. 63.1ml/min GFR, 211.5±366.2mg/dl
vs. 116.29±176 mg/dl proteinuria, p=NS)
Conclusions: In the first phase of Covid-19, with aggressive immunosuppressive reduction, lower mortality was achieved in kidney transplant patients than
generally reported, while no significant problems were experienced in terms of
allograft function and survival. In the second phase, which had a milder course,
severe patient and allograft protection could be achieve