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

Abstract

Introduction Coronavirus disease 2019 [COVID-19] has become a pandemic resulting in a large number of deaths. The complications of COVID-19 are severe in posttransplantation 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 COVID19 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. Correspondence: Arudchelvam Joel E-mail: joelaru@yahoo.com https://orcid.org/0000-0002-4371-4527 Received: 07-09-2021 Accepted: 27-11-2021 DOI: http://doi.org/10.4038/sljs.v39i3.8862 The Sri Lanka Journal of Surgery 2021; 39(3): 71-74 7