Short summary of the impact of the COVID-19 pandemic on donation
and kidney transplant program in Slovakia:
The first patient to test positive for SARS-CoV-2 virus in Slovakia was
reported on 6.3.2020. It was a 52-year-old healthy man with a mild
course of the disease. The last DBD (donation after brain death) donor
and transplantation of two kidneys and one liver before the state of
emergency was declared (15.3.2020) were performed on 11.3.2020. Twelve
days later, measures were taken to limit the transplant program to
urgent life-saving procedures (heart, liver), and kidney transplants
from living and deceased donors were stopped. Due to the favorable
development of the pandemic in Slovakia, kidney transplants from living
and deceased donors were resumed since 14.4.2020, the transplant program
was cleared for all procedures, provided that donors were RT-PCR tested
and strict epidemiological measures were observed. During the summer
months, procurement and transplantation activity intensified to the
average level of 2019, which was the most successful year in the number
of organ transplants in the history of Slovakia. All of the postponed
kidney transplants from living donors were performed. The second wave of
the COVID-19 crisis began in September 2020. For the purposes of our
analysis, the COVID-19 morbidity/mortality in the group of patients
after kidney transplantation was divided in two phases: the first phase
of the second wave (hereinafter ”first period”) from 1.9.2020 to
31.12.2020, and the second phase of the second wave, connected with
proliferation of the alpha variant as confirmed by sequencing
(hereinafter referred to as the ”second period”) from 1.1.2021 to
31.3.2021, when the data collection for this analysis was concluded.
While all four Slovak kidney transplant centers (the University Hospital
in Bratislava, Banská Bystrica, Martin and Košice) proceeded uniformly
during the first wave of COVID-19, during the second wave, when the new
precautionary measures were enacted in an effort to avoid stopping the
transplant program, the individual transplant centers proceeded
according to their individual possibilities, taking into account the
regional epidemic situation.
We present our experience with the development and impact of COVID-19
pandemic on patients after kidney transplantation in Slovakia. We
focused on morbidity and mortality during the two waves of the COVID-19
crisis and tried to identify the risk factors for developing a severe
course of the disease in KTRs. We compared morbidity and mortality of
KTRs with the hemodialysis population.