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Article ; Online: COVID-19 Pandemic Waves and Mortality Among Patients on Kidney Replacement Therapy.

Vart, Priya / Jager, Kitty J / Arnol, Miha / Duivenvoorden, Raphaël / Franssen, Casper F M / Groeneveld, Marc / Hemmelder, Marc H / Lepeytre, Fanny / Malfait, Thomas / Midtvedt, Karsten / Mitra, Sandip / Facundo, Carme / Noordzij, Marlies / Reina, Carlos C / Safak, Seda / Toapanta, Nestor / Hilbrands, Luuk B / Gansevoort, Ron T

Kidney international reports

2022 Volume 7, Issue 9, Page(s) 2091–2096

Language	English
Publishing date	2022-06-20
Publishing country	United States
Document type	Journal Article
ISSN	2468-0249
ISSN (online)	2468-0249
DOI	10.1016/j.ekir.2022.06.007
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Article ; Online: Treatment of early borderline lesions in low immunological risk kidney transplant patients: a Spanish multicenter, randomized, controlled parallel-group study protocol: the TRAINING study.

BMC nephrology

2022 Volume 23, Issue 1, Page(s) 357

Abstract: Background: Subclinical inflammation, including borderline lesions (BL), is very common (30-40%) after kidney transplantation (KT), even in low immunological risk patients, and can lead to interstitial fibrosis/tubular atrophy (IFTA) and worsening of ... ...

Abstract	Background: Subclinical inflammation, including borderline lesions (BL), is very common (30-40%) after kidney transplantation (KT), even in low immunological risk patients, and can lead to interstitial fibrosis/tubular atrophy (IFTA) and worsening of renal function with graft loss. Few controlled studies have analyzed the therapeutic benefit of treating these BL on renal function and graft histology. Furthermore, these studies have only used bolus steroids, which may be insufficient to slow the progression of these lesions. Klotho, a transmembrane protein produced mainly in the kidney with antifibrotic properties, plays a crucial role in the senescence-inflammation binomial of kidney tissue. Systemic and local inflammation decrease renal tissue expression and soluble levels of α-klotho. It is therefore important to determine whether treatment of BL prevents a decrease in α-klotho levels, progression of IFTA, and loss of kidney function. Methods: The TRAINING study will randomize 80 patients with low immunological risk who will receive their first KT. The aim of the study is to determine whether the treatment of early BL (3rd month post-KT) with polyclonal rabbit antithymocyte globulin (Grafalon®) (6 mg/kg/day) prevents or decreases the progression of IFTA and the worsening of graft function compared to conventional therapy after two years post-KT, as well as to analyze whether treatment of BL with Grafalon® can modify the expression and levels of klotho, as well as the pro-inflammatory cytokines that regulate its expression. Discussion: This phase IV investigator-driven, randomized, placebo-controlled clinical trial will examine the efficacy and safety of Grafalon® treatment in low-immunological-risk KT patients with early BL. Trial registration: clinicaltrials.gov : NCT04936282. Registered June 23, 2021, https://clinicaltrials.gov/ct2/show/NCT04936282?term=NCT04936282&draw=2&rank=1 . Protocol Version 2 of 21 January 2022. Sponsor: Canary Isles Institute for Health Research Foundation, Canary Isles (FIISC). mgomez@fciisc.org .
MeSH term(s)	Humans ; Kidney Transplantation/adverse effects ; Kidney Transplantation/methods ; Kidney/pathology ; Kidney Diseases/pathology ; Research Design ; Inflammation/etiology ; Graft Rejection/prevention & control ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic ; Clinical Trials, Phase IV as Topic
Language	English
Publishing date	2022-11-07
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041348-8
ISSN	1471-2369 ; 1471-2369
ISSN (online)	1471-2369
ISSN	1471-2369
DOI	10.1186/s12882-022-02989-z
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Article: Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantation.

Clinical kidney journal

2022 Volume 15, Issue 11, Page(s) 2039–2045

Abstract: Coronavirus disease 2019 (COVID-19) in kidney transplant recipients has a high risk of complications and mortality, especially in older recipients diagnosed during the early period after transplantation. Management of immunosuppression has been ... ...

Abstract	Coronavirus disease 2019 (COVID-19) in kidney transplant recipients has a high risk of complications and mortality, especially in older recipients diagnosed during the early period after transplantation. Management of immunosuppression has been challenging during the pandemic. We investigated the impact of induction immunosuppression, either basiliximab or thymoglobulin, on the clinical evolution of kidney transplant recipients developing COVID-19 during the early period after transplantation. We included kidney transplant recipients with ˂6 months with a functioning graft diagnosed with COVID-19 from the initial pandemic outbreak (March 2020) until 31 July 2021 from different Spanish centres participating in a nationwide registry. A total of 127 patients from 17 Spanish centres developed COVID-19 during the first 6 months after transplantation; 73 (57.5%) received basiliximab and 54 (42.5%) thymoglobulin. Demographics were not different between groups but patients receiving thymoglobulin were more sensitized [calculated panel reactive antibodies (cPRAs) 32.7 ± 40.8% versus 5.6 ± 18.5%] and were more frequently retransplants (30% versus 4%). Recipients ˃65 years of age treated with thymoglobulin showed the highest rate of acute respiratory distress syndrome [64.7% versus 37.1% for older recipients receiving thymoglobulin and basiliximab (
Language	English
Publishing date	2022-04-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2655800-2
ISSN	2048-8513 ; 2048-8505
ISSN (online)	2048-8513
ISSN	2048-8505
DOI	10.1093/ckj/sfac112
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Article: A Prospective Multicenter Trial to Evaluate Urinary Metabolomics for Non-invasive Detection of Renal Allograft Rejection (PARASOL): Study Protocol and Patient Recruitment.

Banas, Miriam C / Böhmig, Georg A / Viklicky, Ondrej / Rostaing, Lionel P / Jouve, Thomas / Guirado, Lluis / Facundo, Carme / Bestard, Oriol / Gröne, Hermann-Josef / Kobayashi, Kazuhiro / Hanzal, Vladimir / Putz, Franz Josef / Zecher, Daniel / Bergler, Tobias / Neumann, Sindy / Rothe, Victoria / Schwäble Santamaria, Amauri G / Schiffer, Eric / Banas, Bernhard

Frontiers in medicine

2022 Volume 8, Page(s) 780585

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2022-01-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2021.780585
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Article ; Online: Management of immunosuppressive therapy in kidney transplant recipients with COVID-19. A multicentre national study derived from the Spanish Society of Nephrology COVID registry.

López-Oliva, María O / Pérez-Flores, Isabel / Molina, María / José Aladrén, María / Trujillo, Hernando / Redondo-Pachón, Dolores / López, Verónica / Facundo, Carme / Villanego, Florentino / Rodríguez, Marisa / Carmen Ruiz, Maria / Antón, Paula / Rivas-Oural, Alba / Cabello, Sheila / Portolés, José / de la Vara, Lourdes / Tabernero, Guadalupe / Valero, Rosalía / Galeano, Cristina /

Moral, Esperanza / Ventura, Ana / Coca, Armando / Ángel Muñoz, Miguel / Hernández-Gallego, Román / Shabaka, Amir / Ledesma, Gabriel / Bouarich, Hanane / Ángeles Rodríguez, María / Pérez Tamajón, Lourdes / Cruzado, Leónidas / Emilio Sánchez, José / Jiménez, Carlos

Nefrologia

2023 Volume 43, Issue 4, Page(s) 442–451

Abstract: Introduction: SARS CoV2 infection has had a major impact on renal transplant patients with a high mortality in the first months of the pandemic. Intentional reduction of immunosuppressive therapy has been postulated as one of the cornerstone in the ... ...

Abstract	Introduction: SARS CoV2 infection has had a major impact on renal transplant patients with a high mortality in the first months of the pandemic. Intentional reduction of immunosuppressive therapy has been postulated as one of the cornerstone in the management of the infection in the absence of targeted antiviral treatment. This has been modified according to the patient`s clinical situation and its effect on renal function or anti-HLA antibodies in the medium term has not been evaluated. Objectives: Evaluate the management of immunosuppressive therapy made during SARS-CoV2 infection, as well as renal function and anti-HLA antibodies in kidney transplant patients 6 months after COVID19 diagnosis. Material and methods: Retrospective, national multicentre, retrospective study (30 centres) of kidney transplant recipients with COVID19 from 01/02/20 to 31/12/20. Clinical variables were collected from medical records and included in an anonymised database. SPSS statistical software was used for data analysis. Results: renal transplant recipients with COVID19 were included (62.6% male), with a mean age of 57.5 years. The predominant immunosuppressive treatment prior to COVID19 was triple therapy with prednisone, tacrolimus and mycophenolic acid (54.6%) followed by m-TOR inhibitor regimens (18.6%). After diagnosis of infection, mycophenolic acid was discontinued in 73.8% of patients, m-TOR inhibitor in 41.4%, tacrolimus in 10.5% and cyclosporin A in 10%. In turn, 26.9% received dexamethasone and 50.9% were started on or had their baseline prednisone dose increased. Mean creatinine before diagnosis of COVID19, at diagnosis and at 6 months was: 1.7 ± 0.8, 2.1 ± 1.2 and 1.8 ± 1 mg/dl respectively (p < 0.001). 56.9% of the patients (N = 350) were monitored for anti-HLA antibodies. 94% (N = 329) had no anti-HLA changes, while 6% (N = 21) had positive anti-HLA antibodies. Among the patients with donor-specific antibodies post-COVID19 (N = 9), 7 patients (3.1%) had one immunosuppressant discontinued (5 patients had mycophenolic acid and 2 had tacrolimus), 1 patient had both immunosuppressants discontinued (3.4%) and 1 patient had no change in immunosuppression (1.1%), these differences were not significant. Conclusions: The management of immunosuppressive therapy after diagnosis of COVID19 was primarily based on discontinuation of mycophenolic acid with very discrete reductions or discontinuations of calcineurin inhibitors. This immunosuppression management did not influence renal function or changes in anti-HLA antibodies 6 months after diagnosis.
MeSH term(s)	Humans ; Male ; Middle Aged ; Female ; Tacrolimus/therapeutic use ; Retrospective Studies ; Mycophenolic Acid/therapeutic use ; Kidney Transplantation ; Prednisone ; Nephrology ; COVID-19 Testing ; RNA, Viral ; COVID-19 ; SARS-CoV-2 ; Immunosuppressive Agents/therapeutic use ; Immunosuppression Therapy ; Antilymphocyte Serum
Chemical Substances	Tacrolimus (WM0HAQ4WNM) ; Mycophenolic Acid (HU9DX48N0T) ; Prednisone (VB0R961HZT) ; RNA, Viral ; Immunosuppressive Agents ; Antilymphocyte Serum
Language	English
Publishing date	2023-09-01
Publishing country	Spain
Document type	Multicenter Study ; Journal Article
ZDB-ID	2837917-2
ISSN	2013-2514 ; 2013-2514
ISSN (online)	2013-2514
ISSN	2013-2514
DOI	10.1016/j.nefroe.2023.08.004
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Article ; Online: COVID-19-related Mortality During the First 60 Days After Kidney Transplantation.

Pascual, Julio / Melilli, Edoardo / Jiménez-Martín, Carlos / González-Monte, Esther / Zárraga, Sofía / Gutiérrez-Dalmau, Alex / López-Jiménez, Veronica / Juega, Javier / Muñoz-Cepeda, Miguel / Lorenzo, Inmaculada / Facundo, Carme / Ruiz-Fuentes, María Del Carmen / Mazuecos, Auxiliadora / Sánchez-Álvarez, Emilio / Crespo, Marta

European urology

2020 Volume 78, Issue 4, Page(s) 641–643

MeSH term(s)	Adult ; Aged ; Betacoronavirus/pathogenicity ; COVID-19 ; Coronavirus Infections/diagnosis ; Coronavirus Infections/immunology ; Coronavirus Infections/mortality ; Coronavirus Infections/virology ; Female ; Host-Pathogen Interactions ; Humans ; Immunocompromised Host ; Immunosuppressive Agents/adverse effects ; Kidney Transplantation/adverse effects ; Kidney Transplantation/mortality ; Male ; Middle Aged ; Opportunistic Infections/diagnosis ; Opportunistic Infections/immunology ; Opportunistic Infections/mortality ; Opportunistic Infections/virology ; Pandemics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/immunology ; Pneumonia, Viral/mortality ; Pneumonia, Viral/virology ; Registries ; Risk Assessment ; Risk Factors ; SARS-CoV-2 ; Spain ; Time Factors ; Treatment Outcome
Chemical Substances	Immunosuppressive Agents
Keywords	covid19
Language	English
Publishing date	2020-06-19
Publishing country	Switzerland
Document type	Letter ; Multicenter Study
ZDB-ID	193790-x
ISSN	1873-7560 ; 1421-993X ; 0302-2838
ISSN (online)	1873-7560 ; 1421-993X
ISSN	0302-2838
DOI	10.1016/j.eururo.2020.06.036
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Article ; Online: Deciphering transplant outcomes of expanded kidney allografts donated after controlled circulatory death in the current transplant era. A call for caution.

Montero, Nuria / Toapanta, Néstor / Pallarès, Natàlia / Crespo, Marta / Diekmann, Fritz / Guirado, Lluis / Esteban, Rafael / Codina, Sergi / Melilli, Edoardo / Buxeda, Anna / Velis, Gonzalo / Torres, Irina B / Revuelta, Ignacio / Molina Andujar, Alicia / Facundo, Carme / Bardají, Beatriz / Riera, Lluís / Fiol, Maria / Cruzado, Josep M /

Comas, Jordi / Giral, Magali / Naesens, Maarten / Åsberg, Anders / Moreso, Francesc / Bestard, Oriol

Transplant international : official journal of the European Society for Organ Transplantation

2021 Volume 34, Issue 12, Page(s) 2494–2506

Abstract: Outcomes of kidney transplantation (KT) after controlled circulatory death (cDCD) with highly expanded criteria donors (ECD) and recipients have not been thoroughly evaluated. We analyzed in a multicenter cohort of 1161 consecutive KT, granular baseline ... ...

Abstract	Outcomes of kidney transplantation (KT) after controlled circulatory death (cDCD) with highly expanded criteria donors (ECD) and recipients have not been thoroughly evaluated. We analyzed in a multicenter cohort of 1161 consecutive KT, granular baseline donor and recipient factors predicting transplant outcomes, selected by bootstrapping and Cox proportional hazards, and were validated in a contemporaneous European KT cohort (n = 1585). 74.3% were DBD and 25.7% cDCD-KT. ECD-KT showed the poorest graft survival rates, irrespective of cDCD or DBD (log-rank < 0.001). Besides standard ECD classification, dialysis vintage, older age, and previous cardiovascular recipient events together with low class-II-HLA match, long cold ischemia time and combining a diabetic donor with a cDCD predicted graft loss (C-Index 0.715, 95% CI 0.675-0.755). External validation showed good prediction accuracy (C-Index 0.697, 95%CI 0.643-0.741). Recipient older age, male gender, dialysis vintage, previous cardiovascular events, and receiving a cDCD independently predicted patient death. Benefit/risk assessment of undergoing KT was compared with concurrent waitlisted candidates, and despite the fact that undergoing KT outperformed remaining waitlisted, remarkably high mortality rates were predicted if KT was undertaken under the worst risk-prediction model. Strategies to increase the donor pool, including cDCD transplants with highly expanded donor and recipient candidates, should be performed with caution.
MeSH term(s)	Aged ; Allografts ; Graft Survival ; Humans ; Kidney ; Kidney Transplantation ; Male ; Tissue Donors
Language	English
Publishing date	2021-10-28
Publishing country	England
Document type	Journal Article ; Multicenter Study
ZDB-ID	639435-8
ISSN	1432-2277 ; 0934-0874
ISSN (online)	1432-2277
ISSN	0934-0874
DOI	10.1111/tri.14131
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Article ; Online: Three cases of monoclonal gammopathy of renal significance after kidney transplantation. De novo C3 glomerulopathy.

Serra, Núria / Facundo, Carme / Canal, Cristina / Arce, Yolanda / Ayasreh, Nadia / Vila, Anna / Bardají, Beatriz / Silva, Irene / López, Víctor / Benito, Silvia / Ballarín, Jose / Guirado, Lluís

Nefrologia

2018 Volume 39, Issue 2, Page(s) 198–201

Abstract: Monoclonal gammopathy of renal significance includes all renal disorders caused by a monoclonal immunoglobulin secreted by a non-malignant B-cell clone. Patients with MGRS do not, by definition, meet criteria for multiple myeloma, with haematological ... ...

Title translation	Tres casos de gammapatía monoclonal de significado renal postrasplante renal: nefropatía c3 de novo.
Abstract	Monoclonal gammopathy of renal significance includes all renal disorders caused by a monoclonal immunoglobulin secreted by a non-malignant B-cell clone. Patients with MGRS do not, by definition, meet criteria for multiple myeloma, with haematological disorders generally considered to be monoclonal gammopathy of undetermined significance. Nevertheless, the renal involvement can be serious and require specific treatment. Monoclonal gammopathy of renal significance is associated with a wide spectrum of disorders, including the recently discovered C3 glomerulopathy. Development of C3 glomerulopathy in the context of monoclonal gammopathy of renal significance after kidney transplantation is uncommon and very few cases have been published to date. We report on three cases of C3 glomerulopathy in the context of de novo monoclonal gammopathy after kidney transplantation.
MeSH term(s)	Aged ; Complement C3 ; Female ; Glomerulonephritis/diagnosis ; Glomerulonephritis/drug therapy ; Glomerulonephritis/etiology ; Humans ; Kidney Diseases/etiology ; Kidney Diseases/immunology ; Kidney Diseases/surgery ; Kidney Transplantation/adverse effects ; Male ; Middle Aged ; Paraproteinemias/complications ; Paraproteinemias/immunology ; Polycystic Kidney Diseases/complications ; Postoperative Complications/drug therapy ; Postoperative Complications/etiology ; Postoperative Complications/immunology ; TRPP Cation Channels/genetics
Chemical Substances	Complement C3 ; TRPP Cation Channels ; polycystic kidney disease 1 protein
Language	Spanish
Publishing date	2018-06-15
Document type	Case Reports ; Journal Article
ZDB-ID	2837917-2
ISSN	2013-2514 ; 2013-2514
ISSN (online)	2013-2514
ISSN	2013-2514
DOI	10.1016/j.nefro.2018.03.008
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Article ; Online: A comprehensive assessment of long-term SARS-CoV-2-specific adaptive immune memory in convalescent COVID-19 Solid Organ Transplant recipients.

Favà, Alexandre / Donadeu, Laura / Jouve, Thomas / Gonzalez-Costello, José / Lladó, Laura / Santana, Carolina / Toapanta, Néstor / Lopez, Manuel / Pernin, Vincent / Facundo, Carme / Cabañas, Nuria Serra / Thaunat, Olivier / Crespo, Marta / Llinàs-Mallol, Laura / Revuelta, Ignacio / Sabé, Nuria / Rombauts, Alexander / Calatayud, Laura / Ardanuy, Carmen /

Esperalba, Juliana / Fernandez, Candela / Lozano, Juan J / Preyer, Rosemarie / Strecker, Kevin / Couceiro, Carlos / García-Romero, Elena / Cachero, Alba / Meneghini, Maria / Torija, Alba / Le Quintrec, Moglie / Melilli, Edoardo / Cruzado, Josep Maria / Polo, Carolina / Moreso, Francesc / Crespo, Elena / Bestard, Oriol

Kidney international

2022 Volume 101, Issue 5, Page(s) 1027–1038

Abstract: Long-term adaptive immune memory has been reported among immunocompetent individuals up to eight months following SARS-CoV-2 infection. However, limited data is available in convalescent patients with a solid organ transplant. To investigate this, we ... ...

Abstract	Long-term adaptive immune memory has been reported among immunocompetent individuals up to eight months following SARS-CoV-2 infection. However, limited data is available in convalescent patients with a solid organ transplant. To investigate this, we performed a thorough evaluation of adaptive immune memory at different compartments (serological, memory B cells and cytokine [IFN-γ, IL-2, IFN-γ/IL12 and IL-21] producing T cells) specific to SARS-CoV-2 by ELISA and FluoroSpot-based assays in 102 convalescent patients (53 with a solid organ transplants (38 kidney, 5 liver, 5 lung and 5 heart transplant) and 49 immunocompetent controls) with different clinical COVID-19 severity (severe, mild and asymptomatic) beyond six months after infection. While similar detectable memory responses at different immune compartments were detected between those with a solid organ transplant and immunocompetent individuals, these responses were predominantly driven by distinct COVID-19 clinical severities (97.6%, 80.5% and 42.1%, all significantly different, were seropositive; 84% vs 75% vs 35.7%, all significantly different, showed IgG-producing memory B cells and 82.5%, 86.9% and 31.6%, displayed IFN-γ producing T cells; in severe, mild and asymptomatic convalescent patients, respectively). Notably, patients with a solid organ transplant with longer time after transplantation did more likely show detectable long-lasting immune memory, regardless of COVID-19 severity. Thus, our study shows that patients with a solid organ transplant are capable of maintaining long-lasting peripheral immune memory after COVID-19 infection; mainly determined by the degree of infection severity.
MeSH term(s)	Antibodies, Viral ; COVID-19 ; Humans ; Immunologic Memory ; Organ Transplantation/adverse effects ; SARS-CoV-2 ; Transplant Recipients
Chemical Substances	Antibodies, Viral
Language	English
Publishing date	2022-02-04
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	120573-0
ISSN	1523-1755 ; 0085-2538
ISSN (online)	1523-1755
ISSN	0085-2538
DOI	10.1016/j.kint.2021.12.029
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Article ; Online: Manejo de la inmunosupresión en pacientes trasplantados de riñón con COVID19. Estudio multicéntrico nacional derivado del registro COVID de la S.E.N.

López-Oliva, María O / Pérez-Flores, Isabel / Molina, María / José Aladrén, Mª / Trujillo, Hernando / Redondo-Pachón, Dolores / López, Verónica / Facundo, Carme / Villanego, Florentino / Rodríguez, Marisa / Carmen Ruiz, Mª / Antón, Paula / Rivas-Oural, Alba / Cabello, Sheila / Portolés, José / de la Vara, Lourdes / Tabernero, Guadalupe / Valero, Rosalía / Galeano, Cristina /

Moral, Esperanza / Ventura, Ana / Coca, Armando / Muñoz, Miguel Ángel / Hernández-Gallego, Román / Shabaka, Amir / Ledesma, Gabriel / Martínez, Patricia / Ángeles Rodríguez, Mª / Tamajón, Lourdes Pérez / Cruzado, Leónidas / Emilio Sánchez, J / Jiménez, Carlos

Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia

2022

Title translation	Management of immunosuppressive therapy in kidney transplant recipients with COVID19. A multicentre national study derived form the S.E.N. COVID registry.
Abstract	Introduction: SARS CoV2 infection has had a major impact on renal transplant patients with a high mortality in the first months of the pandemic. Intentional reduction of immunosuppressive therapy has been postulated as one of the cornerstone in the management of the infection in the absence of targeted antiviral treatment. This has been modified according to the patient`s clinical situation and its effect on renal function or anti-HLA antibodies in the medium term has not been evaluated. Objectives: Evaluate the management of immunosuppressive therapy made during SARS-CoV2 infection, as well as renal function and anti-HLA antibodies in kidney transplant patients 6 months after COVID19 diagnosis. Material and methods: Retrospective, national multicentre, retrospective study (30 centres) of kidney transplant recipients with COVID19 from 01/02/20 to 31/12/20. Clinical variables were collected from medical records and included in an anonymised database. SPSS statistical software was used for data analysis. Results: 615 renal transplant recipients with COVID19 were included (62.6% male), with a mean age of 57.5 years.The predominant immunosuppressive treatment prior to COVID19 was triple therapy with prednisone, tacrolimus and mycophenolic acid (54.6%) followed by m-TOR inhibitor regimens (18.6%). After diagnosis of infection, mycophenolic acid was discontinued in 73.8% of patients, m-TOR inhibitor in 41.4%, tacrolimus in 10.5% and cyclosporin A in 10%. In turn, 26.9% received dexamethasone and 50.9% were started on or had their baseline prednisone dose increased.Mean creatinine before diagnosis of COVID19, at diagnosis and at 6 months was: 1.7±0.8, 2.1±1.2 and 1.8±1 mg/dl respectively (p<0.001).56.9% of the patients (N=350) were monitored for anti-HLA antibodies. 94% (N=329) had no anti-HLA changes, while 6% (N=21) had positive anti-HLA antibodies. Among the patients with donor-specific antibodies post-COVID19 (N=9), 7 patients (3.1%) had one immunosuppressant discontinued (5 patients had mycophenolic acid and 2 had tacrolimus), 1 patient had both immunosuppressants discontinued (3.4%) and 1 patient had no change in immunosuppression (1.1%), these differences were not significant. Conclusions: The management of immunosuppressive therapy after diagnosis of COVID19 was primarily based on discontinuation of mycophenolic acid with very discrete reductions or discontinuations of calcineurin inhibitors. This immunosuppression management did not influence renal function or changes in anti-HLA antibodies 6 months after diagnosis.
Language	Spanish
Publishing date	2022-04-30
Publishing country	Spain
Document type	English Abstract ; Journal Article
ZDB-ID	632512-9
ISSN	1989-2284 ; 0211-6995
ISSN (online)	1989-2284
ISSN	0211-6995
DOI	10.1016/j.nefro.2022.03.008
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