COVID-19 Positivity in Donors Not Linked to Worse 2-Year Kidney Graft Outcomes

Use of kidneys from COVID-19-positive deceased donors is gradually increasing in the United States with favorable short-term graft outcomes, a new study finds.

Tarek Alhamad, MD, MS, of Washington University School of Medicine in St Louis, Missouri, and colleagues studied national trends using 2020-2023 US transplant registry data from 35,851 deceased donors (71,334 kidneys) and 45,912 adult recipients. Active COVID-19 was defined as a positive donor SARS-CoV-2 nucleic acid amplification test (NAT) result within 7 days of procurement and resolved COVID-19 as any COVID-19 positive test more than 7 days before procurement.

The risks for graft failure and death within 2 years of transplantation were no higher for recipients of kidneys from deceased donors with active or resolved COVID-19 than for recipients of kidneys without COVID-19 infection, the investigators reported in JAMA Network Open. Donor COVID-19 positivity also was not significantly associated with greater risk of delayed graft function, acute rejection, or longer hospital stay.

Nonuse of kidneys from COVID-19-positive donors decreased over time, the team reported. Overall, the likelihood of kidney nonuse was 1.6- and 1.3-fold higher for active and resolved COVID-19-positive donors than for negative donors. For active COVID-19 donor kidneys, the odds of nonuse significantly decreased from 11.3-fold in 2020 to 2.1-fold in 2021 to 1.5-fold in 2022. For resolved COVID-19 donor kidneys, the odds of nonuse significantly decreased from 3.9-fold in 2020 to 1.9-fold in 2021. By 2023, use of kidneys from active and resolved COVID-19 donors was similar to that of negative donors, the investigators reported.

“Our findings offer robust evidence suggesting that the use of kidneys from COVID-19–positive donors is safe during medium-term follow-up; however, longer-term follow-up is necessary to further validate this practice,” according to Dr Alhamad’s team.

This article originally appeared on Renal and Urology News