Resuming Deceased Donor Kidney Transplantation in the COVID-19 Era: What Do Patients Want?

Amarpreet K Thind; Hannah Beckwith; Rakesh Dattani; Amrita Dhutia; Sarah Gleeson; Paul Martin; Louise Ryan; Rishana Shuaib; Shuli Svetitsky; Frank J M F Dor; Edwina A Brown; Michelle Willicombe

doi:10.1097/TXD.0000000000001126

Resuming Deceased Donor Kidney Transplantation in the COVID-19 Era: What Do Patients Want?

Transplant Direct. 2021 Mar 5;7(4):e678. doi: 10.1097/TXD.0000000000001126. eCollection 2021 Apr.

Authors

Amarpreet K Thind^{1

2}, Hannah Beckwith¹, Rakesh Dattani², Amrita Dhutia², Sarah Gleeson², Paul Martin², Louise Ryan², Rishana Shuaib², Shuli Svetitsky², Frank J M F Dor^{2

3}, Edwina A Brown^{1

2}, Michelle Willicombe^{1

2}

Affiliations

¹ Division of Immunology and Inflammation, Department of Medicine, Centre for Inflammatory Disease, Imperial College London, London, United Kingdom.
² Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom.
³ Department of Surgery and Cancer, Imperial College, London, United Kingdom.

Abstract

Background: The rapidly evolving novel coronavirus 2019 (COVID-19) pandemic bought many kidney transplant (KT) programs to a halt. Integral to resuming KT activity is understanding the perspectives of potential transplant candidates during this highly dynamic time.

Methods: From June 1 to July 7, 2020, a telephone survey of KT candidates on the deceased donor waiting list at Imperial College Renal and Transplant Centre in West London was conducted. The survey captured ongoing COVID-19 exposure risks and patients' views on waitlist (WL) reactivation and undergoing transplantation.

Results: Two hundred seven responses were received. Of the respondents, 180 patients (87%) were happy to be reactivated onto the WL; with 141 patients (68%) willing to give consent to transplantation currently, while 53 patients (26%) felt unsure, and 13 patients (6%) would decline a KT. The vast majority of patients had no concerns. In the responses from those who were uncertain or who would decline a KT, concerns about COVID-19 infection and the need for reassurance from transplant units dominated. Universally patients wanted more information about COVID-19 infection risk with KT and the precautions being taken to reduce this risk.

Conclusions: The majority of surveyed patients are in favor of reactivation and receiving a KT despite the ongoing COVID-19 pandemic. Reactivation of candidates cannot be assumed and should take an individualized approach, incorporating clinical risk with patient perspectives. Improved communication with KT candidates is highly requested.