As New York City hospitals braced for a potentially overwhelming surge of COVID-19 cases, Columbia University Medical Center nephrologist Sumit Mohan, MD, MPH, and his colleagues had to transform the way they provided kidney transplant care.
“We put a pause on nearly all kidney transplants,” said Mohan, an associate professor of epidemiology and medicine at Columbia University. All elective procedures were put on hold to free up space and ventilators for a surge of COVID-19 patients. For kidney transplant patients with living donors, they decided it was safer to postpone surgeries to prevent donors or immune-suppressed recipients from becoming infected with SARS-CoV-2 in hospitals with large numbers of COVID-19 patients. They concluded that the risks were also too high for most recipients of deceased donors’ kidneys, who in addition to being at risk of infection while immunosuppressed could also experience infection transmission from a donor organ, particularly given the severe shortage of tests for the virus in the early days of the pandemic.
“We inactivated the majority of patients on our kidney transplant list,” he said. Only a small subset of patients who are highly sensitized and unable to accept 99% of donor organs were kept active in case a rare compatible organ became available.
“Our clinics were essentially emptied out except for a small set of urgent visits, Mohan said. “Whatever didn’t need an in-person visit became a telemedicine visit.”