Md Towhid Belal
Dhaka Medical College and Hospital, BangladeshTitle: Is It Time to Implement Self-customized Protocol of Doing Live Donor Renal Transplantation during Covid-19 Pandemic? A High-Volume Center-based Study in Bangladesh
Abstract
Background: Patients of end-stage renal disease are in big trouble of highly likely to be infected with coronavirus during pandemic who requires frequent hospital visits. As a high-volume centre, in our institution, it is very difficult to stop this program suddenly at the start of pandemic. We think that transplantation can isolate and separate these patients in relatively better way in comparison to dialysis. Due to several constraints and limitations, we did not follow the recommended surgical protocols of COVID-19 but we strictly followed our centre-based self-customized strategy during perioperative period to continue our program and to ensure maximum safety to our patients. This paper is to discuss our modified strategy of renal transplantation during whole pandemic period with their outcomes in Centre for Kidney Diseases and Urology Hospital, Dhaka, Bangladesh.
Methods: We retrospectively analysed the data of 300 transplant recipients who underwent renal transplantation during this pandemic along with total 18 members of operation theatre staffs. Asymptomatic with biochemically and radiologically negative for COVID-19 disease patients were selected for surgery without any RT-PCR for COVID-19 tests of both patients and theatre staff. We took several special precautions as our own customized protocols. Incidence of COVID-19 among recipients and operation theatre staffs with their outcomes as well as early outcomes of graft functions were recorded.
Results: Out of 300 recipients, none developed symptoms of COVID-19 during hospital stay before discharge. Total of 18 (6%) patients presented with symptoms of COVID-19 disease during first 4 weeks of discharge, out of them 10 were RT-PCR for COVID-19 positive and 2 COVID-specific deaths were observed. There were total of 7 deaths due to COVID-19 and other complications.
Conclusion: The incidence rate of COVID-19 infection is much lower in recipients but death rate is significantly higher when infected in comparison to general population.
Biography
Md Towhid Belal, 49 years, has completed FCPS in Urology from Bangladesh College of Physicians and Surgeons in 2016. He is currently working as an assistant professor of urology in Dhaka Medical College Hospital, Bangladesh, the largest tertiary level government hospital in the country. He is also working in the Centre for Kidney Disease and Urology Hospital, a private high-volume center of renal transplantation doing five transplant per week and started since 2007. He has over 20 publications. In 2022 he has been rewarded with a gold medal for his innovative work and development in the field of urology. He is the joint secretary of current executive committee of urological association of Bangladesh.
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