PDF(Pubmed)
Abstract：
UNASSIGNED: Coronavirus disease 2019 (COVID-19) poses an important risk of morbidity and of mortality, in patients after solid organ transplantation. Recommendations have been issued by various transplantation societies at the national and European level to manage the immunosuppressive (IS) regimen upon admission to intensive care unit (ICU).
UNASSIGNED: The aim of this study was to evaluate the adequacy of IS regimen minimization strategy in kidney transplant recipients hospitalized in an ICU for severe COVID-19, in relation to the issued recommendations.
UNASSIGNED: The immunosuppressive therapy was minimized in all patients, with respectively 63% and 59% of the patients meeting the local and european recommendations upon admission. During ICU stay, IS was further tapered leading to 85% (local) and 78% (european) adequacy, relative to the guidelines. The most frequent deviation was the lack of complete withdrawal of mycophenolic acid (22%). Nevertheless, the adequacy/inadequacy status was not associated to the ICU- or one-year-mortality.
UNASSIGNED: In this single-center cohort, the only variable associated with a reduction in mortality was vaccination, emphasizing that the key issue is immunization prior to infection, not restoration of immunity during ICU stay.
UNASSIGNED: The aim of this study was to evaluate the adequacy of IS regimen minimization strategy in kidney transplant recipients hospitalized in an ICU for severe COVID-19, in relation to the issued recommendations.
UNASSIGNED: The immunosuppressive therapy was minimized in all patients, with respectively 63% and 59% of the patients meeting the local and european recommendations upon admission. During ICU stay, IS was further tapered leading to 85% (local) and 78% (european) adequacy, relative to the guidelines. The most frequent deviation was the lack of complete withdrawal of mycophenolic acid (22%). Nevertheless, the adequacy/inadequacy status was not associated to the ICU- or one-year-mortality.
UNASSIGNED: In this single-center cohort, the only variable associated with a reduction in mortality was vaccination, emphasizing that the key issue is immunization prior to infection, not restoration of immunity during ICU stay.
摘要：
■2019年冠状病毒病(COVID-19)构成了发病率和死亡率的重要风险，实体器官移植后的患者。各种移植协会已在国家和欧洲层面发布了建议，以在入住重症监护病房（ICU）后管理免疫抑制（IS）方案。
■这项研究的目的是根据已发布的建议，评估在重症COVID-19ICU住院的肾移植受者中IS方案最小化策略的充分性。
■所有患者的免疫抑制治疗都被最小化，分别有63%和59%的患者在入院时符合当地和欧洲的建议。ICU入住期间,IS进一步缩减，导致85%(本地)和78%(欧洲)的充足性，相对于准则。最常见的偏差是缺乏霉酚酸的完全戒断（22％）。然而，充足/不充足状态与ICU或1年死亡率无关.
■在这个单中心队列中，与死亡率降低相关的唯一变量是疫苗接种，强调关键问题是感染前的免疫接种，在ICU入住期间不能恢复免疫力。
■这项研究的目的是根据已发布的建议，评估在重症COVID-19ICU住院的肾移植受者中IS方案最小化策略的充分性。
■所有患者的免疫抑制治疗都被最小化，分别有63%和59%的患者在入院时符合当地和欧洲的建议。ICU入住期间,IS进一步缩减，导致85%(本地)和78%(欧洲)的充足性，相对于准则。最常见的偏差是缺乏霉酚酸的完全戒断（22％）。然而，充足/不充足状态与ICU或1年死亡率无关.
■在这个单中心队列中，与死亡率降低相关的唯一变量是疫苗接种，强调关键问题是感染前的免疫接种，在ICU入住期间不能恢复免疫力。
