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Live donor kidney transplantation in a COVID 19 positive patient: case report and literature review

Authors:

Joel Arudchelvam J ,

Teaching Hospital Anuradhapura, LK
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Neranga Samarasinghe,

National Hospital of Sri Lanka, LK
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Latiff Nazar

National Hospital of Sri Lanka, LK
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Abstract

Introduction
Coronavirus disease 2019 [COVID-19] has become a
pandemic resulting in a large number of deaths. The
compl icat ions of COVID-19 are severe in post -
transplantation patients on immunosuppression, resulting in
more mortality. Therefore renal transplantations [KT] were
stopped temporarily in Sri Lanka during the peak of the
COVID-19 epidemic. And a few months later when the KT
was restarted only patients who were real-time polymerase
chain reaction [PCR] test negative was accepted for KT. This
case report describes a live donor KT done on a patient who
recovered from COVID-19 infection but had persistently
positive PCR test.


Case presentation
A 29-year-old male with end-stage renal failure due to chronic
kidney disease of unknown aetiology underwent a live donor
KT. He had COVID-19 infection more than 4 weeks before
the KT and was asymptomatic with normal chest X-ray
[CXR] and white cell count [WBC]. But his PCR was
positive. The donor was a 41-year-old male. The KT was done
on 2nd February 2021. He had no significant postoperative
complications.


Discussion and conclusions
The main diagnostic tests for COVID-19 infection are PCR
and Rapid antigen tests. PCR detects the viral genomic RNA.
It is known that patients who clinically recover from COVID-
19 infection continue to excrete RNA particles. These are
detected by PCR. Therefore it is suggested that if a patient
clinically recovers from COVID-19 and has normal WBC,
CXR and 6 weeks after the onset of initial infection can
undergo KT safely despite having a positive PCR.

How to Cite: Arudchelvam J J, Samarasinghe N, Nazar L. Live donor kidney transplantation in a COVID 19 positive patient: case report and literature review. Sri Lanka Journal of Surgery. 2021;39(3):71–4.
Published on 30 Nov 2021.
Peer Reviewed

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