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Review
. 2024 Dec;46(1):2336126.
doi: 10.1080/0886022X.2024.2336126. Epub 2024 Apr 16.

COVID-19 and renal allograft rejection: insight from controlled and non-controlled studies

Ahmed Daoud  1   2 , Karim Soliman  1   3 , Maria Aurora Posadas Salas  1 , Genta Uehara  1 , Sakshi Vaishnav  1 , Wisit Cheungpasitporn  4 , Michael J Casey  1
Affiliations
Review

COVID-19 and renal allograft rejection: insight from controlled and non-controlled studies

Ahmed Daoud et al. Ren Fail. 2024 Dec.

Abstract

Aim: Kidney transplant recipients (KTRs), due to their immunosuppressed status, are potentially more susceptible to both the severe effects of COVID-19 and complications in their transplanted organ. The aim of this study is to investigate whether COVID-19 infection increases the risk of rejection in kidney transplant recipients (KTRs).

Methods: This study involved a detailed literature review, conducted using PubMed, with the search being completed by September 7th, 2023. The search strategy incorporated a combination of relevant keywords: 'COVID', 'Renal', 'Kidney', 'Transplant', and 'Rejection'. The results from controlled and uncontrolled studies were separately collated and analyzed.

Results: A total of 11 studies were identified, encompassing 1,179 patients. Among these, two controlled studies reported the incidence of rejection in KTRs infected with COVID-19. Pooling data from these studies revealed no significant statistical correlation between COVID-19 infection and biopsy-proven rejection (p = 0.26). In addition, nine non-controlled studies were found, with rejection incidences ranging from 0% to 66.7%. The majority of these studies (eight out of nine) had small sample sizes, ranging from 3 to 75 KTRs, while the largest included 372 KTRs. The combined rejection rate across these studies was calculated to be 11.8%.

Conclusion: In conclusion, the limited number of published controlled studies revealed no statistically significant association between COVID-19 infection and biopsy-proven rejection among KTRs. However, the broader analysis of non-controlled studies showed a variable rejection incidence with a pooled rejection rate of 11.8%. There is insufficient high-quality data to explore the association of COVID-19 infection and rejection.

Keywords: COVID; kidney; rejection; renal; transplant.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Literature search.
See this image and copyright information in PMC

References

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