Abstract: TH-PO862
Trend in Utilization and Transplant Outcomes of COVID-19-Positive Deceased-Donor Kidneys
Session Information
- Transplantation: Clinical - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Ji, Mengmeng, Washington University in St. Louis, St. Louis, Missouri, United States
- Vinson, Amanda Jean, Dalhousie University, Halifax, Nova Scotia, Canada
- Chang, Su-Hsin, Washington University in St. Louis, St. Louis, Missouri, United States
- Merzkani, Massini, Washington University in St. Louis, St. Louis, Missouri, United States
- Lentine, Krista L., Saint Louis University, Saint Louis, Missouri, United States
- Caliskan, Yasar, Saint Louis University, Saint Louis, Missouri, United States
- Alhamad, Tarek, Washington University in St. Louis, St. Louis, Missouri, United States
Background
While the pandemic of coronavirus disease-19 (COVID-19) enters a new phase and the proportion of individuals with a prior COVID-19 diagnosis grows, the national trend in utilization and medium-term outcomes of kidney transplantation (KT) from COVID-19 positive donors remain unknown. This study evaluated the trend in utilization and KT outcomes of kidneys from donors with active or resolved COVID-19.
Methods
This retrospective cohort study used Standard Analysis and Research (STAR) data from 3/1/2020 to 3/30/2023. The exposure was donor SARS-CoV-2 NAT results, i.e., positive NAT within 7 days as active COVID-19, and positive NAT 7 days before procurement as resolved COVID-19. Kidney non-utilization, graft failure, all-cause death, acute rejection in six months, length of hospital stay (LOS), and delayed graft function (DGF). Multivariable logistic regression for kidney non-utilization, rejection, and DGF, multivariable linear regression for LOS, and Cox analyses for graft failure and all-cause death were performed. All models were adjusted for inverse probability treatment weighting.
Results
The likelihood of non-utilization of kidneys from active or resolved COVID-19+ donors declined over time. During 2020-2022, kidneys from COVID-19+ donors had a higher risk of non-utilization compared to kidneys from donors without COVID-19. In 2023, kidneys from active or resolved COVID-19+ donors were no longer associated with higher risk of non-utilization. No higher risk of graft failure was found in KT recipients receiving active COVID-19+ kidneys (adjusted hazard ratio [aHR], 1.03; 95% CI, 0.78-1.37) or resolved COVID-19+ kidneys (aHR, 1.10; 95% CI, 0.88-1.39). Donor COVID-19 positivity was not associated with all-cause death, longer LOS, higher risk of acute rejection, neither DGF.
Conclusion
This cohort study found that the non-utilization rate of kidneys from COVID-19+ donors declined over time and donor COVID-19 positivity was not associated with inferior KT outcome within 2 years post-transplantation.