Evolving Impact of COVID-19 on Transplant Center Practices and Policies in the United States
Evolving Impact of COVID-19 on Transplant Center Practices and Policies in the United States
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DOI：
10.1111/ctr.14086
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发表时间：
2020-09-28
影响因子：
2.1
通讯作者：
Garonzik-Wang, Jacqueline M.
中科院分区：
文献类型：
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作者：
Boyarsky, Brian J.;Ruck, Jessica M.;Garonzik-Wang, Jacqueline M.
在我们于2020年3月对移植中心进行的首次调查中，超过75%的肾脏和肝脏项目被暂停或受到限制。为了安全地恢复移植，我们必须了解COVID-19对移植受者和中心一级实践的不断变化的影响。因此，我们于2020年5月7日至15日进行了为期六周的跟踪调查，并将回复与COVID-19发病率地图联系起来，回复率为84%。肾脏活体移植的暂停率从3月的72%下降到5月的30%，肝脏从68%下降到52%。限制/暂停死亡供体移植的肾脏从84%下降到58%，肝脏从73%下降到42%。到2020年8月，83%的计划设想恢复正常能力的移植。28%的人报告说，完全使用当地恢复小组进行已故捐赠者的采购。受访者报告共照顾了1166名COVID-19阳性移植受者; 25%病情危重。81%的人报告了远程医疗挑战。对于SARS-CoV-2潜在活体供体或候选人的管理缺乏共识。我们的研究结果表明，即使移植活动恢复，中心层面对COVID-19的反应也存在持续的异质性，因此持续的国家数据收集和实时分析对于提供最佳实践至关重要。
In our first survey of transplant centers in March 2020, >75% of kidney and liver programs were either suspended or operating under restrictions. To safely resume transplantation, we must understand the evolving impact of COVID-19 on transplant recipients and center-level practices. We therefore conducted a six-week follow-up survey May 7-15, 2020, and linked responses to the COVID-19 incidence map, with a response rate of 84%. Suspension of live donor transplantation decreased from 72% in March to 30% in May for kidneys and from 68% to 52% for livers. Restrictions/suspension of deceased donor transplantation decreased from 84% to 58% for kidneys and from 73% to 42% for livers. Resuming transplantation at normal capacity was envisioned by 83% of programs by August 2020. Exclusively using local recovery teams for deceased donor procurement was reported by 28%. Respondents reported caring for a total of 1166 COVID-19-positive transplant recipients; 25% were critically ill. Telemedicine challenges were reported by 81%. There was a lack of consensus regarding management of potential living donors or candidates with SARS-CoV-2. Our findings demonstrate persistent heterogeneity in center-level response to COVID-19 even as transplant activity resumes, making ongoing national data collection and real-time analysis critical to inform best practices.