Kidney Transplants Before and During the COVID-19 Pandemic at the University Hospital of Guadeloupe

Kidney transplantation activity at the University Hospital of Guadeloupe was briefly interrupted at the onset of the COVID-19 pandemic. This study assessed patient and graft survival in 335 recipients transplanted between 2013 and 2023, comparing those transplanted before 2020 and after the resumption of activity. Most patients (70%) received transplants before 2020, with 30% after-ward. ABO compatibility was observed in 98.2% of grafts from brain-dead do-nors. Peak transplant activity occurred in 2018, followed by a decline until 2021 and recovery from 2022. After 2020, recipients were more likely to be el-derly (≥70 years), immunized, obese, have heterozygous sickle cell disease, or polycystic kidney disease (p < 0.05). Mean cold ischemia time decreased (p = 0.009), while warm ischemia time increased (p < 0.001). Graft survival re-mained stable, with 97.5% at 6 months and 89.8% at 4 years for transplants before 2020, versus 100% and 96.9%, respectively, after 2020 (p = 0.160). Patient survival did not differ between periods (p = 0.199). Independent factors associ-ated with mortality included recipient age ≥ 60 years, diabetes, graft failure, transplantation before 2020, cold ischemia time ≥ 1200 minutes, and graft py-elonephritis. Despite an increased proportion of transplants with expanded criteria after 2020, graft and patient survival were not adversely affected.