Why Covid-19 Is Affecting Kidney Transplants

Some hospitals around the country are making the difficult decision to postpone kidney transplants in light of the rapidly spreading coronavirus, which has threatened to overwhelm our health care system.

While this news may be devastating to patients who are on the waiting list or have a living donor, it’s important to understand the medical reasoning behind the decisions. If you are in this situation, be sure to check in with your transplant center to ask for updates. Hospitals are postponing elective surgeries to ensure that hospital beds and medical staff are available for critically-ill patients with COVID-19—and to limit the potential exposure to the virus by other hospital patients.

The CDC has recommended that elective procedures, surgeries and non-urgent outpatient visits be postponed once the virus has started to spread through a community. The U.S. Department of Health and Human Services is allowing hospitals to treat transplants (as well as vascular access surgeries) as non-elective, and many hospitals are continuing to perform transplants if they are not yet experiencing high numbers of coronavirus infections. Hospitals are making their decisions based on the spread of the virus in their own communities, including among health care workers. Because living-donor kidney transplants require two hospital beds and post-surgical recovery care in the hospital, we are hearing that a growing number of transplant centers are temporarily putting living-donor transplants on hold. This both preserves the availability of hospital beds for emergencies and COVID-19 patients, and also keeps non-infected people out of the hospital. Immunosuppressed transplant patients are at high risk for serious illness if they come in contact with the coronavirus that causes COVID-19.

The coronavirus spreads easily from person to person, and can be spread by people who do not show symptoms of COVID-19. This puts anyone who has a compromised immune system—including transplant patients who take immunosuppressive drugs—at an increased risk of becoming infected. Even with social distancing, the virus is still spreading in communities. Newly transplanted patients would be especially vulnerable during their recovery period after transplant surgery. Another obstacle hospitals face is the need to test deceased donors for the coronavirus. Transplanting an organ from a coronavirus-positive patient could present a grave risk to the recipient. With limited test kits needed for living patients, and the lag time between testing and getting results, some hospitals may have to forgo testing—and procuring organs from—deceased donors.