4 Patients being considered for kidney transplant

4 Patients being considered for kidney transplant

4.1 Transplant specialists should discuss the risks and benefits of transplantation in the context of COVID‑19 with patients and their families and carers (as appropriate).For further information, see:

4.2 For patients on the kidney transplant waiting list who have received a letter telling them they are at high risk of severe illness from COVID‑19:

4.3 If patients on the kidney transplant waiting list need dialysis, see the NICE rapid guideline on dialysis service delivery for guidance on minimising their risk of contracting COVID‑19.

4.4 For patients on the kidney transplant waiting list who have symptoms of COVID‑19:

  • suspend them from the waiting list, and do nasopharyngeal swab testing for SARS‑CoV‑2

  • if the test is negative, assess the likelihood that they may have COVID‑19 before returning them to the waiting list (because a negative result does not definitely rule out infection)

  • if the test is positive, assess whether they are well enough to return to the waiting list when they have:

    • recovered from COVID‑19

    • been symptom-free for at least 28 days

    • had a negative swab test result for SARS‑CoV‑2.

4.5 Discuss with patients who have been scheduled for a living donor transplant the importance for them and their household members of self-isolating for 14 days before the transplant if they can. Include in the discussion:

  • their individual risk of contracting COVID-19 and likelihood of a poorer outcome if they do

  • the current local prevalence of COVID-19

  • the delay to transplantation if they contract COVID-19.

    Make a shared decision about self-isolation with patients and their families and carers (as appropriate). [19 August 2020]

4.6 If patients who have been scheduled for a living donor transplant or their household members do not self-isolate, tell them to follow comprehensive social-distancing and hand-hygiene measures for 14 days before the transplant. [19 August 2020]

4.7 Tell patients who have been scheduled for a living donor transplant to:

  • have a nasopharyngeal swab test for SARS-CoV-2 no more than 3 days before admission, with the results available beforehand

  • self-isolate from the day of the test until admission. [19 August 2020]

4.8 For patients who have been scheduled for a living donor transplant and who need dialysis in the 14 days before their transplant, do this in a COVID‑19‑secure area.