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Should Thorax Thin-Section Computed Tomography Be a Standard Diagnostic Procedure in the Evaluation of Potential Kidney Transplant Recipients? Lessons Learned From the COVID-19 Pandemic.

Authors :
Malyszko, Jolanta
Grochowiecki, Tadeusz
Krenke, Rafal
Macech, Michal
Oldakowska-Jedynak, Urszula
Rowiński, Olgierd
Wojtaszek, Ewa
Nazarewski, Slawomir
Source :
Transplantation Proceedings. May2022, Vol. 54 Issue 4, p890-896. 7p.
Publication Year :
2022

Abstract

• High-resolution computed tomography (HRCT) was performed in potential kidney transplant recipients; however, it was intended to exclude the possibility of COVID-19 infection and to provide additional data, including extrapulmonary pathologies. • Despite the possibility of overdiagnosis by HRCT, HRCT should be considered a standard evaluation technique performed in potential kidney transplant recipients. Kidney transplant is the preferred treatment for most patients with end-stage renal disease. Because dialyzed patients often have significant comorbidities or multimorbidities, they should be carefully evaluated before being waitlisted for transplant. The COVID-19 pandemic presents a major challenge for surgery, including transplant surgery. Owing to a fear of COVID-19 symptoms occurring in lungs, thin-section computed tomography (TSCT) became a standard evaluation technique in potential kidney transplant recipients before surgery. The aim of the study was to evaluate the rationale and usefulness of TSCT in deceased donor kidney transplant during the COVID‐19 pandemic. All adult patients who underwent deceased donor kidney transplant between May 1, 2020, and December 15, 2021, were included in the study. Potential kidney transplant recipients who were admitted to the Department of General, Vascular , and Transplant Surgery at the Medical University of Warsaw in Warsaw, Poland, were tested for COVID-19 (CovGenX rapid test); blood chemistries were performed; dialysis was performed (if needed); and, on a negative reverse transcriptase polymerase chain reaction test , HRCT was performed. From May 2020 until the end of December 2021, 54 patients were transplanted; however, 7 patients were disqualified after TSCT and consulted with a pulmonary specialist. Disqualification from kidney transplant accounted for 13% of the potential kidney allograft recipients. Despite the possibility of overdiagnosis by TSCT, TSCT should be considered a standard evaluation technique in potential kidney transplant recipients. Potential kidney transplant recipients must be periodically reassessed given the prolonged wait time for a donor kidney and the significant number of comorbid conditions in this patient population. However, more data with longer follow‐ups are needed to prove or disprove the rationale to use TSCT in transplant surgery. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00411345
Volume :
54
Issue :
4
Database :
Academic Search Index
Journal :
Transplantation Proceedings
Publication Type :
Academic Journal
Accession number :
158423048
Full Text :
https://doi.org/10.1016/j.transproceed.2022.03.044