Fighting Covid with Renal Transplant - Learnings
For a renal / kidney transplant recipient, Covid can be more tricky to handle. Firstly we are immunosuppressed. So our immunity is artificially compromised to ensure that the transplanted organ doesnt get rejected
When we test positive for Covid, we need to first stop the immunosuppressant that keeps the WBC at controlled levels. This means our immunity / WBC needs to be high to fight the Covid
However, this increases the risk of organ rejection due to the likelihood of WBC levels increasing
The saving grace however is that viral infections themselves tend to reduce the WBC levels so the danger of rejection is reduced
However, along with the stoppage of one immunosuppressant, the steroid dosage is increased. In my case it was taken upto 10 mg a day and which will now be tapered down again
This is a balancing act to avoid rejection
At the same time Covid related medication needs to be complemented with Steam Inhalation and Gargles etc. In fact its a good idea for all transplant recipients to go for these treatments even if they are not infected but as a preventive measure
My nephrologist Dr. Bhavesh Vora advised me to use a nasal drop immediately after steam inhalation.
So the virus stays in the paranasal cavity and tends to move to the lungs. The ones in the lungs suddenly flare up after day 7 or Day 8 (as per some internet reading)
Steam and Nasal drops minimize the travel of viral infection to lungs
Along with this anti virals are administered. So the impact of the viral infection is curbed / eliminated as much as possible in the nasal cavity itself
Once it travels to lungs it becomes very tough to control and treat, and there are higher chances of the infected needing specialised treatment like Remdesivir or Oxygen etc as SPO2 levels suddenly drop
So SPO2 is a parameter along with pulse and body temperature that I was testing at least thrice a day. The SpO2 also needed to be measured before and after a 6 minute walk test. This gave a better picture of how these levels are affected by physical activity
A close control of these parameters means any departure from the normal can be treated immediately and aggravation of symptoms can be controlled to a great extent
At the same time we were measuring kidney and liver related readings regularly. Also inflammatory parameters like CRP or D Dimer.
My mother (My organ donor) had a higher D Dimer reading so we treated her with injections as prescribed.
For us things started easing out. I had to do a HRCT scan to find out lung infection and luckily it was in the range of mild to moderate which is not very dangerous, but scary nevertheless
After this stage if the infection in the lungs is at a manageable level the impact of the virus starts declining
As per my understanding the precautions and the initial detection is most critical. The earlier we can start the treatment the easier it is to control the spread of the infection to the lungs and avoid further complications
Once the Covid time period ends, my nephrologist resumed immunosuppression first without reducing the steroids and once the readings stabilise the steroid dosage will also be tapered down
For transplant recipients, it is critical that we rush to a doctor as soon as the very first symptoms are noticed
Symptoms to look out for
Cold with Fever,
Sore Throat
Loose Motions
are the most common symptoms. There is a lot of information available on the internet related to these and its a good idea to study and stay prepared
For others its till the 15 days that define the duration of the infection, but transplant recipients need to be extra careful till the level of immunosuppression reverts to pre covid times
I have also narrated the happenings in my case using 4 blog posts and they are in the links shared below
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@samiirhalady
Please Note that all Medications / Treatments need to be taken only under medical supervision and with a proper prescription
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