2 Transplant recipients
2.1 For patients who have had a kidney transplant:
Review the advice on shielding in UK government guidance on shielding and protecting people defined on medical grounds as extremely vulnerable to COVID-19 with individual patients and their families and carers (as appropriate). Explain how it applies to them, taking into account their particular circumstances and risks.
Explain that the guidance for them may change in the future, as a result of advice from their primary care team, their specialists, or changes in government guidance.
Advise the patient and their families and carers (as appropriate) about attending appointments and how to seek help if they are unwell (see communication and minimising risk).
Ensure the patient has been added to the central shielding list and their GP is aware.
Follow the recommendations in UK government guidance on infection prevention and control for COVID-19 on using personal protective equipment (PPE) when caring for people who are shielding.
2.2 For patients who are stable on their immunosuppressant regimen, assess whether it is safe to do less frequent blood tests for routine monitoring. Discuss any planned changes with the patient and their families and carers (as appropriate).
2.3 Prescribe usual quantities of medicines to meet the patient's clinical needs. Prescribing larger quantities of medicines may put the supply chain at risk.
2.4 If patients develop respiratory symptoms or a fever, consider other possible infective and non-infective causes as well as COVID‑19. Be aware that patients having immunosuppressant treatments may have atypical presentations of COVID‑19. For example, patients taking prednisolone may not develop a fever.
2.5 Think about modifying the immunosuppressant regimen for patients with COVID‑19. The British Transplantation Society and the Renal Association have published guidance on the management of transplant recipients diagnosed with or suspected of having COVID-19.