[KIDNEY TRANSPLANTATION DURING THE SARS-COV-2 PANDEMIC IN ISRAEL: EXPERIENCE FROM A LARGE-VOLUME CENTER].

Introduction: Since its outbreak in December 2019, the coronavirus COVID-19 pandemic has led to global, social, economic and healthcare crises affecting millions of people and causing the death of hundreds of thousands of people worldwide. The pandemic, with its heavy workload, imposed on hospital services and personnel significantly affected solid organ transplantation. Concerns for potential exposure to the virus and its related severe acute respiratory syndrome coronavirus type 2 (SARS-CoV2) have profoundly altered the process of organ donation and recovery, acceptance of organ offers, management of potential recipients and living donors, and above all transplanted and immunosuppressed patients. All those issues required prompt implementation of new practice measures and guidelines as well as continuous adaptations to the fluid and rapidly changing situation.

Methods: This is a single center retrospective analysis, describing our experience with kidney transplantation during the COVID-19 pandemic. Patient's medical records were reviewed and data regarding immunological risk, induction immunosuppression and post-transplant COVID-19 disease were collected and analyzed. We also describe the national and institutional measures and restrictions undertaken in different phases of the pandemic.

Results: A total of 185 patients underwent kidney transplantation between March 1st 2020 and February 28th 2021. Of the 124 living donor kidney transplant recipients and the 61 deceased donor kidney transplant recipients, 4 (3.2%) and 7 patients (11.5%) contracted COVID-19 respectively, whereas 2 (1.6%) and 4 (6.5%) recipients respectively developed severe SARS-CoV2 infection and died.

Conclusions: The COVID-19 pandemic presented an unprecedented challenge to the organ transplant community. The safety and preventive measures undertaken at the Beilinson Transplant Center enabled us to maintain transplant volume with relatively low post-transplant SARS-CoV2 related morbidity and mortality.