Early Impact of COVID-19 on Solid Organ Transplantation in the United States
Early Impact of COVID-19 on Solid Organ Transplantation in the United States
复制标题
DOI：
10.1097/tp.0000000000003391
复制
发表时间：
2020-11-01
期刊：
影响因子：
6.2
通讯作者：
Ahmed, Aijaz
中科院分区：
文献类型：
--
作者：
Cholankeril, George;Podboy, Alexander;Ahmed, Aijaz
背景：2019年冠状病毒病对美国实体器官移植的区域影响尚未得到充分评估。方法：回顾性分析了器官共享联合网络（UNOS）所有地区之间的等待名单增加、等待名单死亡和移植手术的逐月趋势。一个线性回归模型训练的历史数据被用来估计预期transplantation volume.Results.All UNOS regions reported a decrease in total waitlist additions and transplant surgery.总移植量下降最多的是1、2、6和9区，2、7、8和9区的等待名单增加量下降最多。在11个地区中，有6个地区的等待名单死亡人数有所增加，UNOS第9、1和2区都位于东北部，等待名单死亡人数的增幅最高，分别为170%、89%和54%。在肾脏和肺移植中，实体器官移植和等待名单死亡的减少幅度最大。当前移植量显著低于线性回归模型（2182与3110; P < 0.05）得出的95%置信区间的低范围。结论：在美国大多数移植领域，总的等待名单增加和移植手术显著减少，等待名单死亡增加。这种影响在2019年冠状病毒病感染负担高的地区尤为普遍。需要制定旨在尽量减少移植中断的国家和区域战略。
Background.The regional impact of coronavirus disease 2019 on solid organ transplantation in the United States has not been fully evaluated.Methods.A retrospective analysis of month-to-month trends on waitlist additions, waitlist deaths, and transplant surgeries between all United Network for Organ Sharing (UNOS) regions was performed. A linear regression model trained on historical data was used to estimate anticipated transplantation volume.Results.All UNOS regions reported a decrease in total waitlist additions and transplant surgeries. The largest decreases in total transplants were identified in regions 1, 2, 6, and 9, with regions 2, 7, 8, and 9 noting the largest decrease in waitlist additions. Six of the 11 regions noted increases in waitlist deaths, with UNOS regions 9, 1, and 2, all located within the Northeast, noting the highest percent increase in waitlist deaths at 170%, 89%, and 54%, respectively. The largest reductions in solid organ transplantation and waitlist deaths were seen in kidney and lung transplantation. Current transplantation volume is significantly lower than the low range of the 95% confidence interval derived from the linear regression model (2182 versus 3110; P < 0.05).Conclusions.Significant decreases in total waitlist additions and transplant surgeries with increases in waitlist deaths were noted in the majority of US transplant domains. The impact was especially prevalent in areas with high burden of coronavirus disease 2019 infection. National and regional strategies aimed at minimizing disruptions in transplantation are needed.