Abstract
Background: Patients undergoing organ transplantation are immunosuppressed and already at risk of various diseases. We report about a patient who underwent ABO-incompatible kidney transplantation after coronavirus disease 2019 (COVID-19) without a recurrence of infection.
Case report: A 68-year-old woman presented with end-stage renal failure owing to primary autosomal dominant polycystic kidney disease; accordingly, hemodialysis was initiated in September 2020. Her medical history included bilateral osteoarthritis, lumbar spinal stenosis, hypertension, and hyperuricemia. In mid-January 2021, she contracted severe acute respiratory syndrome coronavirus 2 infection from her husband. Both of them were hospitalized and received conservative treatment. Because their symptoms were mild, they were discharged after 10 days. The patient subsequently underwent ABO-incompatible kidney transplantation from her husband who recovered from COVID-19 in March 2021. Before kidney transplantation, her COVID-19 polymerase chain reaction test was negative, confirming the absence of pre-existing COVID-19 immediately before the procedure. Computed tomography revealed no pneumonia. Initial immunosuppression was induced by administering tacrolimus, mycophenolate mofetil, methylprednisolone, basiliximab, rituximab, and 30 g of intravenous immunoglobulin. Double-filtration plasmapheresis and plasma exchange were performed once before ABO-incompatible kidney transplantation. The renal allograft functioned immediately, and the postoperative course was normal without rejection. COVID-19 did not recur. In addition, her serum creatinine levels and renal function had otherwise remained stable.
Conclusion: Living kidney transplantation was safely performed in a patient with COVID-19 without postoperative complications or rejection. During the COVID-19 pandemic, the possibility of severe acute respiratory syndrome coronavirus 2 infection during transplantation surgery must be considered.
【초록키워드】 COVID-19, Methylprednisolone, Treatment, coronavirus disease, Intravenous immunoglobulin, coronavirus, Diseases, Hospitalized, Pneumonia, COVID-19 pandemic, Infection, Immunosuppression, risk, tomography, Symptom, hypertension, renal function, kidney, Hemodialysis, Patient, Osteoarthritis, Complication, Mild, plasma, Immunosuppressed, Allograft, serum creatinine, Hyperuricemia, acute respiratory syndrome, renal, organ, rejection, patient with COVID-19, polymerase chain, postoperative course, performed, addition, remained, absence, postoperative, initiated, discharged, autosomal dominant, end-stage renal failure, 【제목키워드】 transplantation, report,