Pediatric kidney transplantation during the COVID-19 pandemic

Abstract

A waiting list for non-emergency transplant medical care was recommended in the first half of 2020 due to the coronavirus disease 2019 (COVID-19) pandemic. Hence, the number of kidney transplants temporarily declined. However, the waiting list for transplant medical care was lifted in the latter half of 2020 with the establishment of a polymerase chain reaction test system and the spread of infection prevention. The basic stance is to recommend vaccination to post-transplant recipients, recipients, and donors who are scheduled to undergo transplantation, and their families, with the start of vaccine therapy in 2021. The mortality rate of patients undergoing kidney transplants who had COVID-19 is slightly higher than healthy persons, and acute kidney injury was reported to lead to graft loss. However, pediatric cases of severe disease are rare and without deaths. Kidney transplantation medical care will be continuously provided by implementing infection prevention and treatments based on the latest evidence, promoting donated kidney transplantation, and hoping that pediatric patients with renal failure will grow up healthy, both physically and mentally, and become independent members of society, just like healthy children.

Keywords: Kidney transplantation, COVID-19 pandemic, Children

Core Tip: Nearly 60 years have passed since dialysis was first introduced in Japan in 1965 for children with end-stage renal disease. During this period, dialysis therapy, renal transplantation, and renal failure-related treatments (especially clinical applications of erythropoietin and growth hormone) have made remarkable progress, and the era of focusing on prolonging the life of children with end-stage renal disease has completely passed. Patients receiving kidney transplants are at a higher risk of death than the general population during the coronavirus disease 2019 pandemic. However, pediatric cases of severe disease are rare and without deaths. We will continue to provide kidney transplantation medical care by implementing infection prevention measures and treatment based on the latest evidence, and by promoting donated kidney transplantation. We also hope that pediatric patients with renal failure will grow up to be healthy, both physically and mentally, and become independent members of society, just like healthy children.