Practicing With Uncertainty: Kidney Transplantation During the COVID-19 Pandemic.
Practicing With Uncertainty: Kidney Transplantation During the COVID-19 Pandemic.
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DOI：
10.1053/j.ajkd.2020.12.003
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发表时间：
2021-05
期刊：
影响因子：
--
通讯作者：
Josephson MA
中科院分区：
文献类型：
--
作者：
Lentine KL;Mannon RB;Josephson MA
2019 年冠状病毒病 (COVID-19) 大流行要求移植肾科医生、外科医生和护理团队在缺乏经验或数据的情况下就移植计划的全部操作和临床实践做出决策。最初，全国范围内的肾移植手术有所减少，活体捐献和活体移植手术的进行也明显暂停。候选人评估和随访方面迅速转变为远程医疗。疫情爆发几个月后，我们从世界各地的经验中学到了很多东西，但仍然存在许多问题。在本视角中，我们反思了移植界在最初应对大流行时做出的一些实践决定，并考虑了吸取的经验教训，包括与大流行期间继续进行与推迟死者捐赠者移植、活体捐赠和活体捐赠者移植的风险、收益和后勤考虑相关的经验教训。我们回顾了严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染的治疗策略的演变及其在移植受者中的使用、与受感染移植受者免疫抑制管理相关的当前共识，以及有关 SARS-CoV-2 疫苗接种的新信息。我们分享对研究重点的想法，讨论我们仍在不确定性中实践的领域，并展望下一阶段的大流行应对措施。
The coronavirus disease 2019 (COVID-19) pandemic required transplant nephrologists, surgeons, and care teams to make decisions about the full spectrum of transplant program operations and clinical practices in the absence of experience or data. Initially, across the country, there was a reduction in kidney transplant procedures and a striking pause in the conduct of living donation and living-donor transplant surgeries. Aspects of candidate evaluation and follow-up rapidly converted to telehealth. Months into the pandemic, much has been learned from experiences worldwide, yet many questions remain. In this Perspective, we reflect on some of the practice decisions made by the transplant community in the initial response to the pandemic and consider lessons learned, including those related to the risks, benefits, and logistical considerations of proceeding with versus delaying deceased-donor transplantation, living donation, and living-donor transplantation during the pandemic. We review the evolution of therapeutic strategies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and their use in transplant recipients, current consensus related to immunosuppression management in infected transplant recipients, and emerging information on vaccination against SARS-CoV-2. We share our thoughts on research priorities, discuss the areas in which we are still practicing with uncertainty, and look ahead to the next phase of the pandemic response.
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DOI：
10.1056/nejmoa2029849
发表时间：
2021-01-21
期刊：
The New England journal of medicine
影响因子：
--
作者：
Chen P;Nirula A;Heller B;Gottlieb RL;Boscia J;Morris J;Huhn G;Cardona J;Mocherla B;Stosor V;Shawa I;Adams AC;Van Naarden J;Custer KL;Shen L;Durante M;Oakley G;Schade AE;Sabo J;Patel DR;Klekotka P;Skovronsky DM;BLAZE-1 Investigators
通讯作者：
BLAZE-1 Investigators
DOI：
10.5500/wjt.v10.i9.223
发表时间：
2020-09-18
期刊：
World journal of transplantation
影响因子：
--
作者：
Imam A;Tzukert K;Merhav H;Imam R;Abu-Gazala S;Abel R;Elhalel MD;Khalaileh A
通讯作者：
Khalaileh A
影响因子：
6.2
作者：
Bae S;McAdams-DeMarco MA;Massie AB;Ahn JB;Werbel WA;Brennan DC;Lentine KL;Durand CM;Segev DL
通讯作者：
Segev DL
影响因子：
82.9
作者：
He, Xi;Lau, Eric H. Y.;Leung, Gabriel M.
通讯作者：
Leung, Gabriel M.
影响因子：
3.1
作者：
Hoek, Rogier A. S.;Manintveld, Olivier C.;Hesselink, Dennis A.
通讯作者：
Hesselink, Dennis A.