ABSTRACT Background Data demonstrates safety and short‐term success of kidney transplantation (KT) from SARS‐CoV‐2 NAT‐positive organ donors (NAT+) compared to NAT‐negative donors. However, detailed reports of longer‐term graft outcomes are limited and lack granular data on donor SARS‐CoV‐2 infection severity. Methods We retrospectively reviewed records from 220 recipients of KT (KTRs) at our institution from February 1, 2021, to January 31, 2022. We compared 1‐ and 3‐year allograft‐specific outcomes for KTRs from NAT+ ( N = 59), CoV‐COD (COVID as cause of death) ( N = 56), and NAT‐neg ( N = 105) donors. We reviewed and compared pathology findings for allograft biopsies for all groups up to 1 year. We examined the association of eGFR at 3 years with CoV‐donor status using multivariable linear regression. Results At 1 year, there was no difference in rejection or kidney pathologies by CoV‐donor status. At 3 years, there was no difference in patient death or graft loss by group. For subjects without graft loss, eGFR at 3 years for NAT+, CoV‐COD, and NAT‐neg donors was 54.8 (21.8), 45.6(17.9), and 48.4 (23.3) mL/min/m 2 , respectively ( p = 0.61). On multivariable analysis, there was no significant association of eGFR with CoV‐donor status. Conclusions We found no significant difference in pathological findings or 3‐year allograft outcomes following KT from NAT‐negative, NAT+, or CoV‐COD donors. Despite modestly reduced eGFR for COV‐COD on unadjusted analysis, kidneys from donors with a spectrum of COVID severities did not experience significantly poorer allograft outcomes over 3 years. image
Koval et al. (Fri,) studied this question.