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. 2025 Feb;29(2):182-191.
doi: 10.1007/s10157-024-02560-0. Epub 2024 Oct 3.

Outcomes of kidney transplantation in recipients with SARS-cov-2 infection: a 282-case single-center experience in Japan

Eri Sekido  1 , Kohei Unagami  2   3 , Kazuya Omoto  1   4 , Ken Arimura  5 , Ikumi Moriyama  1 , Taro Banno  1 , Ayaka Saitoh  6 , Rikako Oki  6 , Daigo Okada  1 , Takafumi Yagisawa  1 , Taichi Kanzawa  1 , Kumiko Kitajima  6 , Toshihito Hirai  1 , Tomokazu Shimizu  1   6 , Shigeyoshi Yamanaga  7 , Hiroto Egawa  8 , Masashi Inui  1   9 , Junichi Hoshino  10 , Hideki Ishida  6 , Toshio Takagi  1
Affiliations

Outcomes of kidney transplantation in recipients with SARS-cov-2 infection: a 282-case single-center experience in Japan

Eri Sekido et al. Clin Exp Nephrol. 2025 Feb.

Abstract

Background: The coronavirus disease 2019, caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has become a global epidemic. There are concerns regarding the severity of SARS-CoV-2 infections in kidney transplant (KTx) recipients. However, there is limited data on how the epidemic has affected the treatment and prognosis of these patients. Therefore, we aimed to report the changes in the treatment and outcomes of KTx recipients infected with SARS-CoV-2 during each wave at our institution.

Methods: A total of 282 KTx recipients who were infected with SARS-CoV-2 during the study period were followed up at Tokyo Women's Medical University between March 2020 and August 2022. We investigated the outcomes and treatments of infected KTx recipients.

Results: Nineteen (6.7%) patients showed severe outcomes, including eight SARS-CoV-2 infection-related deaths. Risk factors associated with severe outcomes included underlying conditions, such as diabetes mellitus, heart disease, and liver disease (odds ratios, 2.09, 2.88, and 5.52, respectively). Treatment strategies changed throughout the epidemic in response to changes in the SARS-CoV-2 variants. Antiviral drugs were gradually administered as soon as they were approved for use.

Conclusions: Treatment strategies for KTx recipients were gradually established over the course of the epidemic. Although the proportion of infected KTx recipients decreased compared to that of the general population throughout the epidemic, many patients still followed a severe course.

Keywords: COVID-19; Immunosuppressive therapy; Kidney transplantation; SARS-CoV-2.

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Conflict of interest statement

Declarations. Conflict of interest: The authors have declared that no conflict of interest exists. Ethical approval: The study protocol was approved by the Institutional Research Ethics Committee (approval number: 4460) and was in accordance with the guidelines of the 1964 Declaration of Helsinki and its later amendments. Informed consent: Written informed consent was obtained from all participants included in the study.

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