Liver transplantation in the United States during the COVID-19 pandemic: National and center-level responses.
Liver transplantation in the United States during the COVID-19 pandemic: National and center-level responses.
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DOI：
10.1111/ajt.16373
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发表时间：
2021-05
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影响因子：
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新冠肺炎已经深刻地影响了美国的医疗保健系统；它对基于新冠肺炎发病率的肝移植(LT)等待名单的影响尚未得到表征。使用SRTR数据，我们将观察到的LT等待登记、等待名单死亡率、已故供者LTS(DDLT)和在世供者LTS(LDLT)3/15/2020-8/31/2020与基于历史趋势的预期值进行了比较，按全州新冠肺炎发病率分层。总体而言，从3/15到4/30，新上市的公司比预期减少了11%(IRR=0.840.890.93)，LDLT减少了49%(IRR=0.37 0.510.72)，DDLT减少了9%(IRR=0.850.910.97)。5月份，新上市的房源减少了21%(IRR=0.74 0.790.84)，大盘股减少了42%(IRR=0.39 0.580.85)，大盘股增加了13%(IRR=1.07 1.151.23)。发病率最高的州3/15-4/30的中心等待死亡人数增加59%(IRR=1.09 1.592.32)，DDLTS减少34%(IRR=0.50 0.660.86)。到8月份，等待名单的结果正在以预期的速度发生，除了DDLT(在所有事件中都增加了13%)。虽然早期受COVID影响的州经历了重大的移植做法变化，但在大流行后期，新受COVID影响的地区没有受到同样程度的影响。这些结果说明了移植社区在应对大流行和将新知识应用于患者护理方面的适应性。
COVID-19 has profoundly affected the American health care system; its effect on the liver transplant (LT) waitlist based on COVID-19 incidence has not been characterized. Using SRTR data, we compared observed LT waitlist registrations, waitlist mortality, deceased donor LTs (DDLT), and living donor LTs (LDLT) 3/15/2020-8/31/2020 to expected values based on historical trends 1/2016-1/2020, stratified by statewide COVID-19 incidence. Overall, from 3/15 to 4/30, new listings were 11% fewer than expected (IRR = 0.84 0.890.93), LDLTs were 49% fewer (IRR = 0.37 0.510.72), and DDLTs were 9% fewer (IRR = 0.85 0.910.97). In May, new listings were 21% fewer (IRR = 0.74 0.790.84), LDLTs were 42% fewer (IRR = 0.39 0.580.85) and DDLTs were 13% more (IRR = 1.07 1.151.23). Centers in states with the highest incidence 3/15-4/30 had 59% more waitlist deaths (IRR = 1.09 1.592.32) and 34% fewer DDLTs (IRR = 0.50 0.660.86). By August, waitlist outcomes were occurring at expected rates, except for DDLT (13% more across all incidences). While the early COVID-affected states endured major transplant practice changes, later in the pandemic the newly COVID-affected areas were not impacted to the same extent. These results speak to the adaptability of the transplant community in addressing the pandemic and applying new knowledge to patient care.
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影响因子：
8.8
作者：
Huang, Jiao-Feng;Zheng, Kenneth I.;Zheng, Ming-Hua
通讯作者：
Zheng, Ming-Hua
DOI：
10.1001/jamahealthforum.2020.0345
发表时间：
2020-03-02
期刊：
JAMA health forum
影响因子：
--
作者：
Cavallo, Joseph J;Donoho, Daniel A;Forman, Howard P
通讯作者：
Forman, Howard P
DOI：
10.1111/ajt.12777
发表时间：
2014-08
期刊：
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
影响因子：
--
作者：
Massie AB;Kucirka LM;Segev DL
通讯作者：
Segev DL
影响因子：
6.6
作者：
Saigal, Sanjiv;Gupta, Subash;Soin, Arvinder Singh
通讯作者：
Soin, Arvinder Singh
影响因子：
33.9
作者：
Chow, Nancy;Fleming-Dutra, Katherine;Ussery, Emily
通讯作者：
Ussery, Emily