tetano
Editor, Senior Moderator
Transplant Direct
. 2022 Feb 10;8(3):e1292.
doi: 10.1097/TXD.0000000000001292. eCollection 2022 Mar.
Immunosuppression and SARS-CoV-2 Infection in Kidney Transplant Recipients
Arnaud Devresse[SUP] 1 2 [/SUP], Julien De Greef[SUP] 2 3 [/SUP], Jean Cyr Yombi[SUP] 2 3 [/SUP], Leila Belkhir[SUP] 2 3 [/SUP], Eric Goffin[SUP] 1 2 [/SUP], Nada Kanaan[SUP] 1 2 [/SUP]
Affiliations
Abstract
Kidney transplant recipients (KTRs) infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may have an increased risk of mortality compared with the general population and hemodialysis patients. As these patients are immunosuppressed, it might seem obvious to attribute this excess mortality to the impaired immunity induced by immunosuppression. In line with this reasoning is the low immune response, both cellular and humoral, that KTRs mount in response to the anti-SARS-CoV-2 vaccine; however, acute respiratory distress syndrome associated with coronavirus disease 2019 is triggered by a state of inflammation and cytokine release syndrome that lead to pulmonary damage and increased mortality. In that context, immunosuppressive treatment dampening the immune response could, in theory, be potentially beneficial. This review aims at analyzing the current knowledge on the impact of immunosuppressive treatment on mortality in SARS-CoV-2-infected KTRs, the optimal management of immunosuppression in the coronavirus disease 2019 era, and the vaccine response and management in immunosuppressed KTRs.
. 2022 Feb 10;8(3):e1292.
doi: 10.1097/TXD.0000000000001292. eCollection 2022 Mar.
Immunosuppression and SARS-CoV-2 Infection in Kidney Transplant Recipients
Arnaud Devresse[SUP] 1 2 [/SUP], Julien De Greef[SUP] 2 3 [/SUP], Jean Cyr Yombi[SUP] 2 3 [/SUP], Leila Belkhir[SUP] 2 3 [/SUP], Eric Goffin[SUP] 1 2 [/SUP], Nada Kanaan[SUP] 1 2 [/SUP]
Affiliations
- PMID: 35187216
- PMCID: PMC8843373
- DOI: 10.1097/TXD.0000000000001292
Abstract
Kidney transplant recipients (KTRs) infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may have an increased risk of mortality compared with the general population and hemodialysis patients. As these patients are immunosuppressed, it might seem obvious to attribute this excess mortality to the impaired immunity induced by immunosuppression. In line with this reasoning is the low immune response, both cellular and humoral, that KTRs mount in response to the anti-SARS-CoV-2 vaccine; however, acute respiratory distress syndrome associated with coronavirus disease 2019 is triggered by a state of inflammation and cytokine release syndrome that lead to pulmonary damage and increased mortality. In that context, immunosuppressive treatment dampening the immune response could, in theory, be potentially beneficial. This review aims at analyzing the current knowledge on the impact of immunosuppressive treatment on mortality in SARS-CoV-2-infected KTRs, the optimal management of immunosuppression in the coronavirus disease 2019 era, and the vaccine response and management in immunosuppressed KTRs.