Solid-organ transplantation in the period of COVID-19 epidemic

Abstract

COVID-19 significantly changed the approach to the donors and recipients selection for solid-organ transplantation, introducing obligatory lung CT and RT- -PCR for virus presence. In a more distant period from transplantation, the prognosis is affected stronger by advanced age and co-morbidities than by immunosuppression. The first step in the modification of the immunosuppressive regimen is the withdrawal of the antiproliferative agent and maintenance of calcineurin inhibitor and steroids. Immunosuppressive therapy prolongs virus shedding time but may diminish inflammation intensity, decreasing a frequency the severe manifestations. In life-threatening situations, the immunosuppressive treatment is restricted to glucocorticosteroids.