Korean J Transplant.  2023 Nov;37(Suppl 1):S157. 10.4285/ATW2023.F-7434.

Reinitiating living donation kidney transplantation in COVID-19 pandemic: Indonesia experience

• Abdullah A
• Santoso B
• Susalit E
• Hasiholan Marbun MB
• Hidayati EL
• Situmorang GR
• Rasyid N

• KMID: 2551777
• DOI: http://doi.org/10.4285/ATW2023.F-7434

Abstract

Background
The coronavirus disease 2019 (COVID-19) pandemic significantly impacted healthcare procedures, including kidney transplantation (KT). Many global KT centers, including those in Indonesia, suspended programs, especially living donor KT. In April 2020, Indonesia’s Jakarta-based KT centers halted operations after detecting the country’s first COVID-19 case in March 2020. However, after implementing COVID-19 prevention protocols according to international and national health guidelines, the program resumed to adapt to the pandemic era. Nevertheless, comprehensive data on profile, trends, adaptation, and safety measures for living donation KT during the pandemic in Indonesia are lacking. This study aims to collect and report such data.
Methods
This study retrospectively analyzed KT procedures at Dr. Cipto Mangunkusumo Hospital and Asri Hospital, Jakarta, from January 2020 to June 2023. It primarily focused on KT procedures in Indonesia before and after the May 2020 program resumption, implementing COVID-19 prevention protocols.
Results
In January to March 2020, an average of 9.67 KT procedures/month were performed. No KT procedures in April 2020. In May 2020, three KT procedures were done after the reboot. From May 2020 to June 2023, an average of 10 KT procedures/month were performed. Out of 404 KT schedules from May 2020 to June 2023, 382 were performed on schedule, 13 were rescheduled due to non-COVID-19 clinical conditions, and 12 (2.97%) were due to patients COVID-19 infection confirmed by polymerase chain reaction. Pediatric recipients constituted 3.96% of the total recipients. Starting from October 2020, the laparoscopic approach shifted to retroperitoneal to minimize COVID-19 risk. Based on the data, 97% of KT recipients remained uninfected by COVID-19 until this study, while six recipients were infected, two within 14–28 days after the procedure and four after 14–28 days.
Conclusions
Despite COVID-19 challenges, Indonesia’s KT centers adapted, performing more monthly KT procedures than prepandemic. Adjustments like laparoscopic changes and COVID-19 screening ensured safety and continuity, as revealed by this study.