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Higher SARS-CoV-2 Positivity Found Among Kidney Transplant Waitlist Candidates

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Kidney transplant (KT) waitlist candidates may have a higher rate of SARS-CoV-2 positivity than official government data indicate, according to investigators presenting at the virtual American Transplant Congress 2021.

Of 400 waitlist candidates who resided in Georgia counties with an above-average COVID-19 case rate in August 2020, 28 candidates tested positive for antibodies to SARS-CoV-2, yielding a 7% positivity rate. (Use of hemodialysis and peritoneal dialysis was comparable between KT candidates who tested positive and negative.)

Read full article, here.

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Kidney Transplant Rates Recovering After Plummeting Early in the Pandemic

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During the first wave of the COVID-19 pandemic in March-April 2020, kidney waitlist registrations and kidney transplantations plummeted in the United States, followed by encouraging recovery, investigators reported at the virtual American Transplant Congress 2021.

Allan B. Massie, PhD, and collaborators from Johns Hopkins University in Baltimore, Maryland, compared expected with actual rates of transplant services from March to October 2020 using data from The Scientific Registry of Transplant Recipients. Kidney waitlisting dropped from 19% below normal in March to 45% below normal in May, then showed steady recovery through October, when new listings were only 6% below normal, the investigators reported. Waitlist deaths peaked at 72% above expected in March-April, declined to 7% above expected in June, then climbed again to 16% above expected in August, during a second wave of COVID-19 infection.

Read full article, here.

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From avoidance to experiment: How the COVID-19 pandemic impacted organ donation, transplant surgery

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“Organ donation and transplantation surgery came to a screeching halt in March 2020 when doctors feared bringing severely-ill immunocompromised patients into a hospital that was packed over capacity with a highly transmissible airborne infectious disease.

If a patient wasn’t in an intensive care unit (ICU) bed at the onset of the coronavirus (COVID-19) pandemic, they likely were not receiving a transplant at that time.”

Read more, here.

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Transplant patients, some others with immune issues, stuck in limbo as country reopens

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Maria Hoffman feels as though she has been left behind. Her adopted hometown of Charleston, S.C., is hopping – with restaurants and bars fully open, park concerts in full swing and maskless friends reuniting with hugs on streets.

Hoffman, 39, is fully vaccinated and eager to rejoin the world. But as a kidney transplant patient, she is hesitant to participate for fear of becoming infected. “Risk is very different for people in my situation,” she said. “I am 100% acting like I am not immunized.”

The state worker is among millions of immunocompromised Americans, about 3 to 4% of the U.S. population, for whom the shots may not work fully, or at all, and who are unsure of their place in a country that is increasingly opening up. Emerging research shows that 15 to 80% of those with certain conditions, such as specific blood cancers or who have had organ transplants, are generating few antibodies.

Read the full story, here.

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Improving Lung Capacity Pre- and Post-COVID-19

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“For many patients admitted to the hospital with COVID-19, surviving the virus is only half of the battle. Once deemed virus-free and ready to be sent home, the often-long road to recovery – including rebuilding lung capacity and overall respiratory health – begins.

Two Cedars-Sinai respiratory therapists explain what roadblocks these hospital-admitted patients face when it comes to lung health and offer tips for non-patients looking to improve their overall respiratory health.

“Patients with COVID-19 tend to be sicker for much longer than other patients with respiratory-related illnesses and, on average, stay on a ventilator for a longer duration,” said Dagoberto Naranjo, RRT, a respiratory therapist in the Department of Respiratory Therapy at Cedars-Sinai.

These ventilated patients also take longer to react, or benefit from, oxygenation efforts, according to Naranjo.”

Read full article, here.

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Despite COVID Vaccinations, Caution Still Crucial for Transplant Recipients

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“Long before COVID-19 changed the world, organ transplant recipients were wearing masks to shield themselves from airborne threats.

Immunosuppressive medicines, which often are a lifelong requirement after a transplant, add an extra layer of protection against viruses as common as a cold or as dangerous as COVID. Transplant patients are told to use masks for any group gatherings or airplane flights, and hand sanitizing is a must. 

While COVID has brought a heightened awareness of these patients’ health risks and fragility, a recent study by Johns Hopkins University researchers in Baltimore, Maryland, and a report from the Mayo Clinic in Jacksonville, Florida, may raise their sense of unease even further.”

Read the full article, here.

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Antibody Response to 2-Dose SARS-CoV-2 mRNA Vaccine Series in Solid Organ Transplant Recipients

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“Transplant recipients without prior polymerase chain reaction–confirmed COVID-19 were recruited from across the US to participate in this prospective cohort through a digital campaign. Those who completed the 2-dose SARS-CoV-2 mRNA vaccine series between December 16, 2020, and March 13, 2021, were included and followed up through April 13, 2021. As described previously,3 semiquantitative antispike serologic testing was undertaken with the Roche Elecsys anti–SARS-CoV-2 S enzyme immunoassay, positive cutoff of at least 0.8 U/mL, which tests for the receptor-binding domain of the SARS-CoV-2 spike protein, or the EUROIMMUN enzyme immunoassay, positive cutoff of at least 1.1 arbitrary units, which tests for the S1 domain of SARS-CoV-2 spike protein, both key measures of humoral immune response.4,5 This study was approved by the Johns Hopkins institutional review board; participants provided informed consent electronically.

The proportion of patients who developed a positive antibody response was assessed with an exact binomial confidence interval. The Fisher exact test was used to compare categorical variables, such as antimetabolite immunosuppression, and the Kruskal-Wallis test for continuous variables. All tests were 2-sided with α = .05. Analyses were performed using Stata 16.1/Windows.”

See the full study results, here.

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When You’ve Been Fully Vaccinated: How to Protect Yourself and Others

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  • If you are fully vaccinated you can start doing many things that you had stopped doing because of the pandemic.
  • When choosing safer activities, consider how COVID-19 is spreading in your community, the number of people participating in the activity, and the location of the activity.
  • Outdoor visits and activities are safer than indoor activities, and fully vaccinated people can participate in some indoor events safely, without much risk.
  • If you haven’t been vaccinated yet, find a vaccine.

Find all recent updates from the CDC, here.

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First COVID-19 Vaccine Dose Elicits Weak Antibody Response in Most KTRs

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“Most adult kidney transplant recipients (KTRs) exhibit a weak antibody response to the first injection of the Moderna mRNA COVID-19 vaccine, according to the findings of a prospective study published in Kidney International.1

“We already know that kidney transplant recipients tend to respond less well to vaccines because of the immunosuppression, but data concerning the anti-SARS-CoV-2 antibody response after COVID-19 vaccine in this population were lacking,” said first author Ilies Benotmane, MD, of Strasbourg University Hospital and the Fédération de Médecine Translationnelle (FMTS) in Strasbourg, France.

COVID-19 vaccine distribution programs worldwide have given priority to immunocompromised patients, including KTRs. Vaccination was recommended, however, for this patient population even though KTRs were not included in the vaccine clinical trials. Dr Benotmane and colleagues conducted a preliminary study investigating the efficacy and safety of the Moderna mRNA-1273 vaccine in KTRs by looking at the anti SARS CoV-2 antibody response after the first injection.”

Read more, here.

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Preguntas Frecuentes Acerca del COVID-19

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“La División de Trasplantes (DoT, siglas en inglés) de la Administración de Recursos y Servicios de Salud (HRSA, siglas en inglés) está controlando el impacto de la emergencia de salud pública por coronavirus (COVID-19) sobre la procuración y el trasplante de órganos.

¿Debería inscribirme como donante de órganos durante el brote de COVID-19?

Si no es donante de órganos registrado, le sugerimos que se inscriba en línea a través de su registro estatal de donantes. Inscribirse significa que, algún día, podría salvar vidas.”

Mas informacion aqui.

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