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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Urologiia</journal-id><journal-title-group><journal-title xml:lang="en">Urologiia</journal-title><trans-title-group xml:lang="ru"><trans-title>Урология</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1728-2985</issn><issn publication-format="electronic">2414-9020</issn><publisher><publisher-name xml:lang="en">Bionika Media</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">312657</article-id><article-id pub-id-type="doi">10.18565/urology.2021.4.87-92</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Articles</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Статьи</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Kidney transplantation from Covid-19 positive deceased donor: what are the consequences for recipients?</article-title><trans-title-group xml:lang="ru"><trans-title>Трансплантация почки от Covid-19-инфицированного трупного донора: каковы последствия для реципиентов?</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Perlin</surname><given-names>D. V</given-names></name><name xml:lang="ru"><surname>Перлин</surname><given-names>Д. В</given-names></name></name-alternatives><bio xml:lang="en"><p>M.D., Full Professor, Chief Physician</p></bio><bio xml:lang="ru"><p>д.м.н., профессор, главный врач</p></bio><email>dvperlin@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Alexandrov</surname><given-names>I. V</given-names></name><name xml:lang="ru"><surname>Александров</surname><given-names>И. В</given-names></name></name-alternatives><bio xml:lang="en"><p>M.D., Ph.D. doctoral candidate (M), Deputy Chief Physician</p></bio><bio xml:lang="ru"><p>к.м.н.; доцент, заместитель главного врача</p></bio><email>argenza@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Shmanev</surname><given-names>A. O</given-names></name><name xml:lang="ru"><surname>Шманев</surname><given-names>А. О</given-names></name></name-alternatives><bio xml:lang="en"><p>oncologist</p></bio><bio xml:lang="ru"><p>врач-онколог</p></bio><email>sparta238@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Dymkov</surname><given-names>I. N</given-names></name><name xml:lang="ru"><surname>Дымков</surname><given-names>И. Н</given-names></name></name-alternatives><bio xml:lang="en"><p>M.D., Ph.D. doctoral candidate (M); Deputy Chief Physician</p></bio><bio xml:lang="ru"><p>к.м.н., заместитель главного врача</p></bio><email>dymkoff2303@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Perlina</surname><given-names>A. V</given-names></name><name xml:lang="ru"><surname>Перлина</surname><given-names>А. В</given-names></name></name-alternatives><bio xml:lang="en"><p>dermatologist</p></bio><bio xml:lang="ru"><p>врач-дерматолог</p></bio><email>japp@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Wolgograd Regional Center of Urology and Nephrology</institution></aff><aff><institution xml:lang="ru">Волгоградский областной уронефрологический центр</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Moscow Regional Research and Clinical Institute</institution></aff><aff><institution xml:lang="ru">ГБУЗ «Московский областной научно-исследовательский клинический институт им. М. Ф. Владимирского»</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2021-08-15" publication-format="electronic"><day>15</day><month>08</month><year>2021</year></pub-date><issue>4</issue><issue-title xml:lang="en">NO4 (2021)</issue-title><issue-title xml:lang="ru">№4 (2021)</issue-title><fpage>87</fpage><lpage>92</lpage><history><date date-type="received" iso-8601-date="2023-03-03"><day>03</day><month>03</month><year>2023</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2021, Bionika Media</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2021, ООО «Бионика Медиа»</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="en">Bionika Media</copyright-holder><copyright-holder xml:lang="ru">ООО «Бионика Медиа»</copyright-holder></permissions><self-uri xlink:href="https://journals.eco-vector.com/1728-2985/article/view/312657">https://journals.eco-vector.com/1728-2985/article/view/312657</self-uri><abstract xml:lang="en"><p>Introduction. In recent months, with the spread of COVID 19, the number of kidney transplants from deceased donors has declined significantly in most countries. One of the reasons is the possibility of infection of the recipient with SARS-CoV-2. Determining the risk of transmission of COVID 19 with a donor organ is very important for developing a kidney transplantation policy during a pandemic. Material and method. We present cases of kidney transplantation from COVID 19 positive deceased donor to two dialysis patients in single center. Deceased donor: a 45 years old man with diabetes, who had a major hemorrhagic stroke resulting in brain death. He had normal urine output and serum creatinine level for last 24 hours before kidney harvesting. For a few hours after organ harvesting, the donor was diagnosed COVID 19 (retrospective nasopharyngeal swab rRT-PCR which was confirmed by morphological examination and RNA-PCR of specimens from the trachea and bronchus). Recipient 1: a 49 years old man with polycystic kidney disease had been on hemodialysis for 28 months. He was in urgent list because of problems with vascular access. So non identical ABO (0-donor, B-recipient) kidney transplantation from this deceased donor was done in May 2020. Recipient 2: a 45 years old man with polycystic kidney disease on continuous ambulatory peritoneal dialysis (CAPD). Не was registered on urgent waiting list because of low transport capacity of peritoneum. Kidney transplantation from the same deceased donor was done at the same time. In both cases we completely abandoned any antilymphocytic agents for induction, despite non ABO identical transplantation in one of the recipients and the delayed graft function. Both patients received only basic immunosuppression, including tacrolimus, methylprednisolone and a mycophenolic acid. Results. In first case cold ischemia time was 22 hours. The recipient had delayed graft function with increasing of urine output on day 8 post-transplant. No other deviations from the usual course were seen during hospital stay. The patient was discharge from hospital with serum creatinine level 122 mkmol/L. The cold ischemia time was 21 hours in another patient. Graft function was immediate with a decrease serum creatinine to 92.5 mkmol/L at discharge. Both patients had no febrile and no other symptoms of acute respiratory disease during all hospital stay. No abnormalities on chest X-ray were seen. No serum anti-SARS-CoV-2 IgM and IgG were detected before and during 6 weeks after surgery. Repeated nasopharyngeal swabs rRT-PCR were negative during all the period. Both recipients were discharged for 5 weeks after surgery to prevent out-of-hospital contamination of COVID 19, which would be difficult to differentiate from transmission infection. After 9 months both patients are doing well with no clinical or laboratory signs of COVID-19. Conclusion. Today we have no evidence of the possibility of transmission of COVID-19 from a SARS-Cov-2 positive donor to a kidney recipient. We also have no reason to suspect kidney damage by COVID-19 in a deceased donor at normal serum creatinine level. Avoiding the use of anti-lymphocyte drugs for induction of immunosuppression may also reduce the risk of developing COVID19 after transplantation. A careful collection and analysis of such dates is necessary to develop modern practical recommendations for transplant centers.</p></abstract><trans-abstract xml:lang="ru"><p>Введение. За последние месяцы в связи с распространением COVID-19 количество трансплантаций почек от умерших доноров значительно сократилось в большинстве стран. Одна из причин - возможность заражения реципиента. Определение риска трансмиссии COVID-19 донорским органом очень важно для разработки политики трансплантации почки во время пандемии. Материалы и методы. Мы представляем первые известные наблюдения трансплантации почки от трупного донора, у которого был ретроспективно подтвержден COVID-19 двум диализным пациентам в одном центре. Трупный донор: мужчина 45 лет, страдавший диабетом, у которого произошел тяжелый геморрагический инсульт, приведший к смерти мозга в мае 2020 г. В течение последних суток перед эксплантацией органов у донора сохранялся нормальный диурез и уровень креатинина в сыворотке. На следующий день после изъятия и трансплантации почек двум реципиентам у донора был ретроспективно диагностирован COVID-19. Первый реципиент: мужчина 49 лет с поликистозом почек, находился на гемодиализе 28 мес. Из-за проблем с сосудистым доступом был включен в ургентный лист ожидания. Трансплантация почки от описанного трупного ABO - неидентичного (О -донор, B -реципиент) донора была выполнена с периодом холодовой консервации 22 ч. Второй реципиент: мужчина 45 лет с поликистозом почек, находившийся на постоянном амбулаторном перитонеальном диализе с низким KT/V. Трансплантация почки была выполнена почти одновременно с продолжительностью холодовой ишемии 21 ч. В обоих случаях не использовали препараты антилимфоцитарных антител для индукции иммуносупрессии. Оба пациента получали только базовую терапию, включившую такролимус, метилпреднизолон и микофеноловую кислоту. Результаты. У первого реципиента была отсроченная функция трансплантата с увеличением диуреза на 8-й день после операции. Других отклонений от обычного курса во время пребывания в больнице не наблюдалось. Пациент выписан из стационара с уровнем креатинина сыворотки 122 мкмоль/л. У второго реципиента функция трансплантата была немедленной со снижением уровня креатинина сыворотки до 92,5 мкмоль/л ко дню выписки. У обоих пациентов не было ни лихорадки, ни других симптомов острого респираторного заболевания на протяжении всего пребывания в стационаре. На повторных трентгенограммах грудной клетки отклонений не было. В течение 6 нед. после операции сывороточные IgM и IgG к SARS-CoV-2 не обнаружены. Повторные мазки из носоглотки выписаны через 5 нед. после операции, чтобы предотвратить внебольничное заражение COVID-19. Через 9 мес. оба пациента чувствовали себя хорошо, клинических или лабораторных признаков COVID-19 нет. Заключение. Сегодня у нас нет доказательств возможности трансмиссии заболевания реципиенту от COVID-19-положительного донора через почечный трансплантат. У нас также нет оснований предполагать прямое или косвенное поражение почек COVID-19-позитивного трупного донора при нормальном уровне креатинина сыворотки. Отказ от использования антилимфоцитарных препаратов для индукции иммуносупрессии, возможно, снижает риск развития COVID-19 после трансплантации. Тщательный сбор и анализ подобных наблюдений необходимы для разработки актуальных практических рекомендаций для клинической трансплантологии в период пандемии.</p></trans-abstract><kwd-group xml:lang="en"><kwd>COVID-19</kwd><kwd>COVID-19</kwd><kwd>kidney transplantation</kwd><kwd>deceased donor</kwd><kwd>acute kidney injury</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>трансплантация почки</kwd><kwd>трупный донор</kwd><kwd>острое повреждение почки</kwd></kwd-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Bellini M.I., Francesco T., Marco C. Kidney Transplantation And The Lockdown Effect. Transplant International. 2020. Doi:10.1111/ tri.13639.</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Ashay S., Bahadur M.M., Raina S. COVID-19 In Recent Kidney Transplant Recipients. American Journal of Transplantation. 2020. 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