Covid-19 doesn't seem to be going away any time soon. More patients are being admitted in hospitals than in previous months. People are now returning to normal activities. The real number of infected Filipinos is now unknown particularly since most are doing self-testing and likely no longer reporting themselves as positive.
This puts immunocompromised patients at risk, since now we really don't know the extent of Covid's reach in the country. And although most are vaccinated, the immunocompromised individuals like transplant patients can still get sick and would do well to remain vigilant and be extra careful.
Just as with all other aspects of society, medicine and patient care have to find their way back, because every day there are more people developing hypertension, diabetes, chronic kidney disease and starting dialysis. Transplantation is no exception.
That said, I've compiled a few frequently asked questions that might help guide you during your discussions with your transplant team.
Are transplant recipients at higher risk of getting Covid-19?
Because transplant recipients take immunosuppressive drugs, transplant patients have a higher risk of infection from viruses such as the cold or flu. To lower the chance of getting the coronavirus that causes Covid-19, transplant patients should follow proper recommendations on how to avoid catching or spreading germs, and contact their doctor if they develop symptoms of Covid-19. We still don't have definitive information on whether Covid-19 infection will be more severe in transplant recipients compared to healthy people. However, other viruses often cause more severe disease in people whose immune system is low, such as transplant recipients.
How can Covid-19 affect transplant surgeries?
The risk of acquiring Covid-19 from organ donation is low. Donors are screened for Covid-19 symptoms and exposure history. Living donors who have been to high-risk areas or exposed to someone diagnosed or being evaluated for Covid-19 infection are generally being asked to postpone donation for 14 to 28 days after returning.
It is currently still recommended that certain elective surgeries and non-essential procedures be delayed, and that includes transplantation. Some centers may still need to look at temporarily putting elective living donor transplantation or non-urgent deceased donor transplants on hold. Transplant centers will base these decisions on issues such as the level of circulating Covid-19 infection in their areas and/or operational issues (such as testing availability, bed space, availability of basic supplies and equipment, including personal protective equipment).
Also, living donors are being asked to not travel to high-risk areas for at least 14 days before donation and monitor for symptoms. Information about recent travel and possible exposure is also asked about deceased donors to help determine if they are safe for organ and tissue donation.
Should transplant recipients be worried about living with loved ones who go out in public or work outside the home?
A person who is living with someone who has contracted Covid-19 is at risk of also becoming infected. This is especially true for post transplant patients. So it becomes even more important for anyone to limit going into the public, especially if there is an active and expanding outbreak in their area, or if authorities recommend remaining in place in an effort to maintain social distancing to help control the spread of the virus.
If people need to go into public, then they should take certain precautions, including limiting the time spent outside as much as possible, avoiding large crowds, and maintaining social distance (at least 6 feet). People with a kidney transplant should also consult with their healthcare team to find out what precautions should be taken by them and their caregivers. This might include additional hand washing/sanitizing, face coverings, or other measures.
There are always going to be questions when thinking about getting a kidney transplant. Covid just added more. But at some point, you have to weigh the risks and benefits of getting a kidney transplant versus continuing on with having chronic kidney disease and being on dialysis. Covid is going to be here for a while, so discuss with your doctor whether a kidney transplant is right for you.
