Short summary of the impact of the COVID-19 pandemic on donation and kidney transplant program in Slovakia:
The first patient to test positive for SARS-CoV-2 virus in Slovakia was reported on 6.3.2020. It was a 52-year-old healthy man with a mild course of the disease. The last DBD (donation after brain death) donor and transplantation of two kidneys and one liver before the state of emergency was declared (15.3.2020) were performed on 11.3.2020. Twelve days later, measures were taken to limit the transplant program to urgent life-saving procedures (heart, liver), and kidney transplants from living and deceased donors were stopped. Due to the favorable development of the pandemic in Slovakia, kidney transplants from living and deceased donors were resumed since 14.4.2020, the transplant program was cleared for all procedures, provided that donors were RT-PCR tested and strict epidemiological measures were observed. During the summer months, procurement and transplantation activity intensified to the average level of 2019, which was the most successful year in the number of organ transplants in the history of Slovakia. All of the postponed kidney transplants from living donors were performed. The second wave of the COVID-19 crisis began in September 2020. For the purposes of our analysis, the COVID-19 morbidity/mortality in the group of patients after kidney transplantation was divided in two phases: the first phase of the second wave (hereinafter ”first period”) from 1.9.2020 to 31.12.2020, and the second phase of the second wave, connected with proliferation of the alpha variant as confirmed by sequencing (hereinafter referred to as the ”second period”) from 1.1.2021 to 31.3.2021, when the data collection for this analysis was concluded. While all four Slovak kidney transplant centers (the University Hospital in Bratislava, Banská Bystrica, Martin and Košice) proceeded uniformly during the first wave of COVID-19, during the second wave, when the new precautionary measures were enacted in an effort to avoid stopping the transplant program, the individual transplant centers proceeded according to their individual possibilities, taking into account the regional epidemic situation.
We present our experience with the development and impact of COVID-19 pandemic on patients after kidney transplantation in Slovakia. We focused on morbidity and mortality during the two waves of the COVID-19 crisis and tried to identify the risk factors for developing a severe course of the disease in KTRs. We compared morbidity and mortality of KTRs with the hemodialysis population.