The Global Impact of COVID-19 on Solid Organ Transplantation: Two Years Into a Pandemic.
The Global Impact of COVID-19 on Solid Organ Transplantation: Two Years Into a Pandemic.
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DOI：
10.1097/tp.0000000000004151
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发表时间：
2022-07-01
期刊：
影响因子：
6.2
通讯作者：
中科院分区：
文献类型：
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作者：
2019冠状病毒病（COVID-19）大流行对实体器官移植（SOT）产生了重大的全球影响。据估计，2020年全球移植活动减少了16%，对肾移植和活体供者计划的影响最为显著，对等待名单上的患者产生了巨大的连锁反应。严重急性呼吸系统综合征冠状病毒2型（SARS-CoV-2）感染风险的增加和移植候选人的过度死亡导致了在大流行的第二年优先考虑安全重新启动和继续移植计划的重大努力，移植率恢复到大流行前的水平。在过去的2年里，SOT接受者的COVID-19死亡率从20%-25%下降到8%-10%，这归因于SARS-CoV-2检测的增加和早期可用性，坚持非药物干预，开发新的治疗方法和疫苗接种。尽管采取了这些积极的步骤，移植计划和SOT接受者继续面临挑战。SOT接种者的疫苗有效性大大低于一般人群，如果他们患上COVID-19，SOT接种者的不良后果风险仍会增加。SOT接受者和移植团队需要保持警惕，持续坚持非药物干预似乎至关重要。在这篇综述中，我们总结了COVID-19在过去2年中对移植活动、供体评估和患者结局的全球影响，讨论了目前旨在预防和治疗SOT受者SARS-CoV-2感染的策略，并根据从这次大流行中吸取的教训，提出了移植界可以考虑为未来大流行做准备的步骤。
The coronavirus disease 2019 (COVID-19) pandemic has had a major global impact on solid organ transplantation (SOT). An estimated 16% global reduction in transplant activity occurred over the course of 2020, most markedly impacting kidney transplant and living donor programs, resulting in substantial knock-on effects for waitlisted patients. The increased severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection risk and excess deaths in transplant candidates has resulted in substantial effort to prioritize the safe restart and continuation of transplant programs over the second year of the pandemic, with transplant rates returning towards prepandemic levels. Over the past 2 y, COVID-19 mortality in SOT recipients has fallen from 20%–25% to 8%–10%, attributed to the increased and early availability of SARS-CoV-2 testing, adherence to nonpharmaceutical interventions, development of novel treatments, and vaccination. Despite these positive steps, transplant programs and SOT recipients continue to face challenges. Vaccine efficacy in SOT recipients is substantially lower than the general population and SOT recipients remain at an increased risk of adverse outcomes if they develop COVID-19. SOT recipients and transplant teams need to remain vigilant and ongoing adherence to nonpharmaceutical interventions appears essential. In this review, we summarize the global impact of COVID-19 on transplant activity, donor evaluation, and patient outcomes over the past 2 y, discuss the current strategies aimed at preventing and treating SARS-CoV-2 infection in SOT recipients, and based on lessons learnt from this pandemic, propose steps the transplant community could consider as preparation for future pandemics.
影响因子：
5.1
作者：
Russo MW;Kwok R;Serper M;Ufere N;Hameed B;Chu J;Goacher E;Lingerfelt J;Terrault N;Reddy KR
通讯作者：
Reddy KR