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Kidney Week

Abstract: PO0773

Kidney Transplant Practices in Latin America During the COVID-19 Pandemic: Analysis from GlomCon Latin America Working Group (LGlomCon)

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Rodriguez Ramirez, Sonia, University Health Network, Toronto, Ontario, Canada
  • Cabeza Rivera, Franco H., University of Mississippi Medical Center, Jackson, Mississippi, United States
  • Gutierrez-Prieto, Julio Alejandro, Hospital Central del Estado de Chihuahua, Chihuahua, Chihuahua, Mexico
  • Soto-Vargas, Javier, Hospital General Regional 46, Guadalajara, Jalisco, Mexico
  • Martinez-Chagolla, Blanca, Hospital General “Dr. Miguel Silva”, Morelia, Michoacan, Mexico
  • Arellano-Mendez, Denisse, Unidad Medica de Atencion Ambulatoria 254, IMSS, Morelia, Michoacan, Mexico
  • Aguirre, Diana, Hospital General de Mexicali, Mexicali, Baja California, Mexico
  • Garcia Anton, Desiree, University of Mississippi Medical Center, Jackson, Mississippi, United States
  • Avila-Casado, Carmen, University Health Network, Toronto, Ontario, Canada

Group or Team Name

  • GlomCon Latin America Working Group (LGlomCon)
Background

Latin America (LA) is the current epicenter of a global pandemic that has never been seen in the era of transplantation and immunotherapy. We aimed to describe their nephrologists’ practices and experiences regarding kidney transplant (KT) management in the context of COVID-19 pandemic.

Methods

Descriptive analysis extracted from an online survey carried out among nephrologists, renal pathologists and other health workers treating kidney diseases between May 20-27, 2020 from sixteen Spanish speaking LA countries divided into 6 categories. We present the results for the kidney transplant category.

Results

430 responses were obtained of which 360 (84%) were considered for analysis. 139 (49%) respondents routinely participate in the care of transplant patients at centers that perform up to 50 KT per year (70% of them). The transplant activity was suspended in 90% of the centers at the time of the survey. Bigger centers continued their activity but not at full capacity. For transplant recipients who developed COVID-19, 52% of physicians continued the same maintenance immunosuppression for the ones with mild disease (outpatient). For moderate cases (inpatient but not requiring mechanical ventilation or vasopressors), 72% decreased maintenance therapy starting with the antiproliferative drug. For severe cases (ICU admission for mechanical ventilation or vasopressors), 74% stopped all the immunotherapy with the exception of steroids. ICU admission and need for renal replacement therapy were reported in less than 20% of their cases. Nephrologists from centers that continued their transplant activity during the pandemic reported that only 32% performed routine COVID-19 tests to donors and 51% to recipients before KT surgery.

Conclusion

Kidney transplants programs are almost closed throughout LA during the COVID-19 pandemic. The disproportionate resource allocation to COVID-19 will have unintended consequences for those already carrying the burden of health inequality with the potential to disadvantage marginalized patients further. Reported immunosuppression management is in line with transplant societies' recommendations.

Funding

  • Private Foundation Support