Modification of immunosuppressive agents in a kidney transplant recipient with COVID-19 and acute kidney injury

Modification of immunosuppressive agents in a kidney transplant recipient with COVID-19 and acute kidney injury

Introduction: An outbreak of coronavirus disease-19 (COVID-19) has occurred in different parts of the world. Although a large piece of information regarding the epidemiology, clinical features, and management of COVID-19 has been reported in the general population, there is very limited data regard...

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Main Authors: Thanawat Vongchaiudomchoke, Vittawin Sawangduan, Tosapon Sinpanee, Nipon Chalermphunchai, Kumtorn Lelamali, Kajohnsak Noppakun
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2021-09-01
Series:Journal of Infection in Developing Countries
Subjects:
calcineurin inhibitors
drug interaction
immunosuppressive adjustment
immunosuppressive regimen
kidney transplantation
pneumonia
Online Access:https://jidc.org/index.php/journal/article/view/13176
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Summary:Introduction: An outbreak of coronavirus disease-19 (COVID-19) has occurred in different parts of the world. Although a large piece of information regarding the epidemiology, clinical features, and management of COVID-19 has been reported in the general population, there is very limited data regarding organ transplant recipients, particularly regarding the management of maintenance immunosuppressive agents during infection. Methodology: We described a case of kidney transplant recipient from Thailand who had COVID-19 pneumonia and severe acute kidney injury. Results: The patient’s serum creatinine peaked at 7.0 mg/dL on day 15 of illness and returned to baseline value of 2.0 mg/dL on day 26 of illness. We have shown how we modified tacrolimus, mycophenolate, and steroids in the patient who had received favipiravir and lopinavir/ritonavir for COVID-19 pneumonia. Conclusions: In this case, successful modification of this immunosuppressive regimen was accomplished to reduce drug interaction complications, aiming to avoid calcineurin inhibitor nephrotoxicity while maintaining appropriate levels of immunosuppression to prevent organ rejection and to promote the patient’s recovery from infection.
ISSN:1972-2680

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