Comparison of Short-Term Outcomes in Kidney Transplant Recipients from SARS-CoV-2–Infected versus Noninfected Deceased Donors

Abstract

Background Acceptable post-transplant outcomes were reported in kidney transplant recipients from donors with coronavirus disease 2019 (COVID-19); however, there are no comparative studies with well-matched controls. Methods This multicenter, prospective observational study, which included three transplant centers in the United States, enrolled 61 kidney recipients from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–infected deceased donors. Using optimal matching methods, we matched every recipient to three comparators receiving kidneys from SARS-CoV-2–negative deceased donors with otherwise highly similar characteristics in the same transplant centers to compare 6-month eGFR. Results Among recipients of SARS-CoV-2–infected donor kidneys, one recipient died with a functional graft within 6 months. Mean 6-month eGFR was not significantly different between SARS-CoV-2–infected and noninfected donor groups (55±21 and 57±25 ml/min per 1.73 m2, respectively; P = 0.61). Six-month eGFR in recipients from SARS-CoV-2–infected donors who died of reasons other than COVID-19 was not significantly different from those from SARS-CoV-2–negative donors (58±22 and 56±25 ml/min per 1.73 m2, respectively; P = 0.51). However, recipients from donors who died of COVID-19 had significantly lower 6-month eGFR than those from SARS-CoV-2–negative donors (46±17 and 58±27 ml/min per 1.73 m2, respectively; P = 0.03). No donor-to-recipient SARS-CoV-2 transmission was observed. Conclusions Six-month eGFR was not significantly different between recipients of kidneys from SARS-CoV-2–infected and noninfected donors. However, those receiving kidneys from donors who died of COVID-19 had significantly lower 6-month eGFR. Donor-to-recipient SARS-CoV-2 transmission was not observed.