COVID-19 and kidney transplantation: an Italian Survey and Consensus
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COVID‑19 and kidney transplantation: an Italian Survey and Consensus Fabio Vistoli1 · Lucrezia Furian2 · Umberto Maggiore3 · Rossana Caldara4 · Vincenzo Cantaluppi5 · Mariano Ferraresso6 · Gianluigi Zaza7 · Massimo Cardillo8 · Giandomenico Biancofiore9 · Francesco Menichetti10 · Alessandro Russo10 · Emanuela Turillazzi11 · Marco Di Paolo11 · Giuseppe Grandaliano12 · Ugo Boggi1 · on behalf of the Italian National Kidney Transplantation Network · the Joint Committee of the Italian Society of Organ Transplantation and the Italian Society of Nephrology Received: 6 May 2020 / Accepted: 15 May 2020 © Italian Society of Nephrology 2020
Abstract Italy was the first Western country to face the COVID-19 pandemic. Here we report the results of a national survey on kidney transplantation activity in February and March 2020, and the results of a three-round Delphi consensus promoted by four scientific societies: the Italian Society of Organ Transplantation, the Italian Society of Nephrology, the Italian Society of Anesthesia and Intensive Care, and the Italian Group on Antimicrobial Stewardship. All 41 Italian transplant centers were invited to express their opinion in the Delphi rounds along with a group of seven experts. The survey revealed that, starting from March 2020, there was a decline in kidney transplantation activity in Italy, especially for living-related transplants. Overall, 60 recipients tested positive for SARS-CoV2 infection, 57 required hospitalization, 17 were admitted to the ICU, and 11 died. The online consensus had high response rates at each round (95.8%, 95.8%, and 89.5%, respectively). Eventually, 27 of 31 proposed statements were approved (87.1%), 12 at the first or second round (38.7%), and 3 at the third (9.7%). Based on the Italian experience, we discuss the reasons for the changes in kidney transplantation activity during the COVID-19 pandemic in Western countries. We also provide working recommendations for the organization and management of kidney transplantation under these conditions. Keywords COVID-19 · Kidney transplantation · Survey · Consensus
Introduction SARS-CoV2 is a positive-sense RNA virus belonging to the family of coronaviruses. It causes a flu-like syndrome of varying severity, that is potentially deadly. This disease Fabio Vistoli and Lucrezia Furian are joint first authors. Giuseppe Grandaliano and Ugo Boggi are joint senior authors. The members of Italian National Kidney Transplantation Network are listed in acknowledgement section. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40620-020-00755-8) contains supplementary material, which is available to authorized users. * Gianluigi Zaza [email protected] Extended author information available on the last page of the article
is characterized by one or more of the following symptoms: fever, cough, myalgia, asthenia, dyspnea, sore throat, and diarrhea [1]. The virus was first identified in December 2019 in Wuhan (C
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