Kidney transplants in the COVID-19 era

For many patients on the waiting list for a kidney transplant, getting a notification that a kidney is available is a dream come true, and a chance to live free from the taxing dialysis routine that’s ruled their lives. But what do you do when your perfect match is found in the age of COVID-19? Should you have the transplant? Or lose the opportunity, and wait until vaccines are available?

We believe that patients critically in need of a kidney transplant should forge ahead with their surgery. At UofL Health – Trager Transplant Center, we have spent a great deal of time evaluating risk, looking at recommendations from our national health authorities, and stepping up our infectious disease protocols. And we believe we can continue to offer kidney transplants safely and effectively to patients, even in these unusual circumstances.

Why do we believe this? A recent statement from the American Society of Transplantation classified the risk of contracting COVID from transplanted organs as low. This is because of the COVID protocols in place, which include:

  • Vetting of donations from deceased donors, to determine they did not have or were in contact with anyone having COVID-19.
  • Living donors are tested for the illness as well. If they have been to high-risk areas or exposed to someone diagnosed with COVID, they are asked to quarantine for 14 to 28 days before donating a kidney.
  • Every recipient that comes in for a transplant of any kind is tested upon arrival and kept safe throughout the entire process include pre-transplant through recovery.
  • The Centers for Disease Control and Prevention (CDC) has also recommended that “high need, high acuity” patients who need transplants should not delay them.

With all this in mind, how has the COVID-19 crisis impacted the way we do business at UofL Health – Trager Transplant Center?

Specifically, we are:

  • Focusing on the kidney transplant patients who have the most serious, pressing needs. This includes patients who have been on dialysis the longest, or those who are medically fragile, or pediatric patients for whom a rare match has been found, among other issues.
  • Per the CDC’s guidance, we are putting elective living donor transplantation or non-urgent deceased donor transplants on hold, based on the levels of circulating COVID-19 infection in our area. Determination on how many procedures we undertake will be made on a day-to-day basis.
  • We are asking all living donors not to travel for two weeks before donating a kidney.
  • We are also advising our kidney transplant patients to quarantine not to travel before receiving their transplant.
  • We’re requesting that transplant patients observe all mask wearing and social distancing guidelines and continue to quarantine themselves as much as they are able both before and after the transplant process.
  • UofL Health has COVID-19 protocols in place in throughout our hospital system, requiring everyone entering the building to wear masks, and for our staff to wear medical grade PPE equipment including masks. Hands must be washed when entering a patient’s room, and strict visitor policies are in place for caregivers.
  • Once the patient returns home, many follow-up appointments are being held via telehealth to reduce exposure to COVID-19.

While getting transplant surgery is safe, the suppressed immune system patients will have, as a result of anti-rejection drugs, is an ongoing concern in the COVID era. We work with patients to ensure that they are doing everything they can to keep themselves safe while they recover and give them strategies post-recovery that can help them stay infection-free.

The COVID pandemic has made this a challenging medical landscape for us all. But we are still here to meet the needs of kidney transplant patients who urgently need our care. If you have any questions about our pandemic protocols, we’d be happy to discuss them with you. Feel free to contact my office at 502-588-4710.

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About Lina Mackelaite, M.D.

Dr. Lina Mackelaite was born in Vilnius, Lithuania. She finished medical school there with her husband, who is also a nephrologist. In 2009, she finished an internal medicine residency and general nephrology fellowship at Drexel University. Dr. Mackelaite also completed a transplant fellowship at Westchester Medical Center in New York. In 2010, she and her family moved to Louisville and she joined UofL Physicians – Nephology with a focus on transplant nephrology. She loves spending time outdoors hiking or biking with her three children, as well as, playing the cello.

All posts by Lina Mackelaite, M.D.