COVID-19 pandemic and worldwide organ transplantation: a population-based study
Summary: Background: Preliminary data suggest that COVID-19 has reduced access to solid organ transplantation. However, the global consequences of the COVID-19 pandemic on transplantation rates and the effect on waitlisted patients have not been reported. We aimed to assess the effect of the COVID-...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-10-01
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| Series: | The Lancet Public Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468266721002000 |
| _version_ | 1819129512979333120 |
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| author | Olivier Aubert, MD Daniel Yoo, MPH Dina Zielinski, PhD Emanuele Cozzi, MD Massimo Cardillo, MD Michael Dürr, MD Beatriz Domínguez-Gil, MD Elisabeth Coll, MD Margarida Ivo Da Silva, MD Ville Sallinen, MD Karl Lemström, MD Karsten Midtvedt, MD Camilo Ulloa, MD Franz Immer, MD Annemarie Weissenbacher, MD Natalie Vallant, MD Nikolina Basic-Jukic, MD Kazunari Tanabe, MD Georgios Papatheodoridis, PhD Georgia Menoudakou, MSc Martin Torres, MD Carlos Soratti, MD Daniela Hansen Krogh Carmen Lefaucheur, MD Gustavo Ferreira, MD Helio Tedesco Silva, Jr, MD David Hartell, MA John Forsythe, MD Lisa Mumford, MSc Peter P Reese, MD François Kerbaul, MD Christian Jacquelinet, MD Serge Vogelaar, MD Vassilios Papalois, MD Alexandre Loupy, MD |
| author_facet | Olivier Aubert, MD Daniel Yoo, MPH Dina Zielinski, PhD Emanuele Cozzi, MD Massimo Cardillo, MD Michael Dürr, MD Beatriz Domínguez-Gil, MD Elisabeth Coll, MD Margarida Ivo Da Silva, MD Ville Sallinen, MD Karl Lemström, MD Karsten Midtvedt, MD Camilo Ulloa, MD Franz Immer, MD Annemarie Weissenbacher, MD Natalie Vallant, MD Nikolina Basic-Jukic, MD Kazunari Tanabe, MD Georgios Papatheodoridis, PhD Georgia Menoudakou, MSc Martin Torres, MD Carlos Soratti, MD Daniela Hansen Krogh Carmen Lefaucheur, MD Gustavo Ferreira, MD Helio Tedesco Silva, Jr, MD David Hartell, MA John Forsythe, MD Lisa Mumford, MSc Peter P Reese, MD François Kerbaul, MD Christian Jacquelinet, MD Serge Vogelaar, MD Vassilios Papalois, MD Alexandre Loupy, MD |
| author_sort | Olivier Aubert, MD |
| collection | DOAJ |
| description | Summary: Background: Preliminary data suggest that COVID-19 has reduced access to solid organ transplantation. However, the global consequences of the COVID-19 pandemic on transplantation rates and the effect on waitlisted patients have not been reported. We aimed to assess the effect of the COVID-19 pandemic on transplantation and investigate if the pandemic was associated with heterogeneous adaptation in terms of organ transplantation, with ensuing consequences for waitlisted patients. Methods: In this population-based, observational, before-and-after study, we collected and validated nationwide cohorts of consecutive kidney, liver, lung, and heart transplants from 22 countries. Data were collected from Jan 1 to Dec 31, 2020, along with data from the same period in 2019. The analysis was done from the onset of the 100th cumulative COVID-19 case through to Dec 31, 2020. We assessed the effect of the pandemic on the worldwide organ transplantation rate and the disparity in transplant numbers within each country. We estimated the number of waitlisted patient life-years lost due to the negative effects of the pandemic. The study is registered with ClinicalTrials.gov, NCT04416256. Findings: Transplant activity in all countries studied showed an overall decrease during the pandemic. Kidney transplantation was the most affected, followed by lung, liver, and heart. We identified three organ transplant rate patterns, as follows: countries with a sharp decrease in transplantation rate with a low COVID-19-related death rate; countries with a moderate decrease in transplantation rate with a moderate COVID-19-related death rate; and countries with a slight decrease in transplantation rate despite a high COVID-19-related death rate. Temporal trends revealed a marked worldwide reduction in transplant activity during the first 3 months of the pandemic, with losses stabilising after June, 2020, but decreasing again from October to December, 2020. The overall reduction in transplants during the observation time period translated to 48 239 waitlisted patient life-years lost. Interpretation: We quantified the impact of the COVID-19 pandemic on worldwide organ transplantation activity and revealed heterogeneous adaptation in terms of organ transplantation, both at national levels and within countries, with detrimental consequences for waitlisted patients. Understanding how different countries and health-care systems responded to COVID-19-related challenges could facilitate improved pandemic preparedness, notably, how to safely maintain transplant programmes, both with immediate and non-immediate life-saving potential, to prevent loss of patient life-years. Funding: French national research agency (INSERM) ATIP Avenir and Fondation Bettencourt Schueller. |
| first_indexed | 2024-12-22T08:44:54Z |
| format | Article |
| id | doaj.art-eb04f7c21b8347bd8e36f5a796f765ba |
| institution | Directory Open Access Journal |
| issn | 2468-2667 |
| language | English |
| last_indexed | 2024-12-22T08:44:54Z |
| publishDate | 2021-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Public Health |
| spelling | doaj.art-eb04f7c21b8347bd8e36f5a796f765ba2022-12-21T18:32:08ZengElsevierThe Lancet Public Health2468-26672021-10-01610e709e719COVID-19 pandemic and worldwide organ transplantation: a population-based studyOlivier Aubert, MD0Daniel Yoo, MPH1Dina Zielinski, PhD2Emanuele Cozzi, MD3Massimo Cardillo, MD4Michael Dürr, MD5Beatriz Domínguez-Gil, MD6Elisabeth Coll, MD7Margarida Ivo Da Silva, MD8Ville Sallinen, MD9Karl Lemström, MD10Karsten Midtvedt, MD11Camilo Ulloa, MD12Franz Immer, MD13Annemarie Weissenbacher, MD14Natalie Vallant, MD15Nikolina Basic-Jukic, MD16Kazunari Tanabe, MD17Georgios Papatheodoridis, PhD18Georgia Menoudakou, MSc19Martin Torres, MD20Carlos Soratti, MD21Daniela Hansen Krogh22Carmen Lefaucheur, MD23Gustavo Ferreira, MD24Helio Tedesco Silva, Jr, MD25David Hartell, MA26John Forsythe, MD27Lisa Mumford, MSc28Peter P Reese, MD29François Kerbaul, MD30Christian Jacquelinet, MD31Serge Vogelaar, MD32Vassilios Papalois, MD33Alexandre Loupy, MD34Université de Paris, INSERM, PARCC, Paris Translational Research Centre for Organ Transplantation, Paris, France; Kidney Transplant Department, Necker Hospital, Assistance Publique—Hôpitaux de Paris, Paris, FranceUniversité de Paris, INSERM, PARCC, Paris Translational Research Centre for Organ Transplantation, Paris, FranceUniversité de Paris, INSERM, PARCC, Paris Translational Research Centre for Organ Transplantation, Paris, FranceTransplant Immunology Unit, Department of Cardio-Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy; Italian National Transplant Center, Istituto Superiore di Sanità, Rome, ItalyItalian National Transplant Center, Istituto Superiore di Sanità, Rome, ItalyDivision of Nephrology and Internal Intensive Care Medicine, Charité-Universitätsmedizin, Berlin, GermanyOrganización Nacional de Transplantes, Madrid, SpainOrganización Nacional de Transplantes, Madrid, SpainInstituo portuges de sangue e da transplantacao, Lisbon, PortugalDepartment of Transplantation and Liver Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, FinlandDepartment of Cardiothoracic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, FinlandDepartment of Transplant Medicine, Oslo University Hospital, Rikshospitalet, Oslo, NorwayNephrology Department, Clínica Alemana de Santiago—UDD, Santiago, ChileSwisstransplant, Bern, SwitzerlandDepartment of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Medical University of Innsbruck, Innsbruck, AustriaDepartment of Transplant Surgery, Faculty of Medicine, Imperial College London, London, UKDepartment of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, CroatiaDepartment of Urology, Tokyo Women's Medical University, Tokyo, JapanHellenic Transplant Organization, Athens, GreeceHellenic Transplant Organization, Athens, GreeceInstituto Nacional Central Único Coordinador de Ablación e Implante (INCUCAI), Buenos Aires, ArgentinaInstituto Nacional Central Único Coordinador de Ablación e Implante (INCUCAI), Buenos Aires, ArgentinaInstituto Nacional Central Único Coordinador de Ablación e Implante (INCUCAI), Buenos Aires, ArgentinaUniversité de Paris, INSERM, PARCC, Paris Translational Research Centre for Organ Transplantation, Paris, France; Department of Nephrology and Kidney Transplantation, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, FranceDepartment of Medicine, Santa Casa de Juiz de Fora, Juiz de Fora, BrazilDivision of Nephrology, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, BrazilCanadian Blood Services, Ottawa, ON, CanadaNHS Blood and Transplant, Stoke Gifford, Bristol, UKStatistics and Clinical Studies, NHS Blood and Transplant, Bristol, UKUniversité de Paris, INSERM, PARCC, Paris Translational Research Centre for Organ Transplantation, Paris, France; Department of Medicine, Renal-Electrolyte and Hypertension Division, University of Pennsylvania, Philadelphia, PA, USA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USAAgence de la Biomédecine, Saint Denis la Plaine, FranceAgence de la Biomédecine, Saint Denis la Plaine, FranceEurotransplant International Foundation, Leiden, NetherlandsDepartment of Surgery, Faculty of Medicine, Imperial College London, London, UKUniversité de Paris, INSERM, PARCC, Paris Translational Research Centre for Organ Transplantation, Paris, France; Kidney Transplant Department, Necker Hospital, Assistance Publique—Hôpitaux de Paris, Paris, France; Correspondence to: Prof Alexandre Loupy, Paris Translational Research Center for Organ Transplantation, Paris 75015, FranceSummary: Background: Preliminary data suggest that COVID-19 has reduced access to solid organ transplantation. However, the global consequences of the COVID-19 pandemic on transplantation rates and the effect on waitlisted patients have not been reported. We aimed to assess the effect of the COVID-19 pandemic on transplantation and investigate if the pandemic was associated with heterogeneous adaptation in terms of organ transplantation, with ensuing consequences for waitlisted patients. Methods: In this population-based, observational, before-and-after study, we collected and validated nationwide cohorts of consecutive kidney, liver, lung, and heart transplants from 22 countries. Data were collected from Jan 1 to Dec 31, 2020, along with data from the same period in 2019. The analysis was done from the onset of the 100th cumulative COVID-19 case through to Dec 31, 2020. We assessed the effect of the pandemic on the worldwide organ transplantation rate and the disparity in transplant numbers within each country. We estimated the number of waitlisted patient life-years lost due to the negative effects of the pandemic. The study is registered with ClinicalTrials.gov, NCT04416256. Findings: Transplant activity in all countries studied showed an overall decrease during the pandemic. Kidney transplantation was the most affected, followed by lung, liver, and heart. We identified three organ transplant rate patterns, as follows: countries with a sharp decrease in transplantation rate with a low COVID-19-related death rate; countries with a moderate decrease in transplantation rate with a moderate COVID-19-related death rate; and countries with a slight decrease in transplantation rate despite a high COVID-19-related death rate. Temporal trends revealed a marked worldwide reduction in transplant activity during the first 3 months of the pandemic, with losses stabilising after June, 2020, but decreasing again from October to December, 2020. The overall reduction in transplants during the observation time period translated to 48 239 waitlisted patient life-years lost. Interpretation: We quantified the impact of the COVID-19 pandemic on worldwide organ transplantation activity and revealed heterogeneous adaptation in terms of organ transplantation, both at national levels and within countries, with detrimental consequences for waitlisted patients. Understanding how different countries and health-care systems responded to COVID-19-related challenges could facilitate improved pandemic preparedness, notably, how to safely maintain transplant programmes, both with immediate and non-immediate life-saving potential, to prevent loss of patient life-years. Funding: French national research agency (INSERM) ATIP Avenir and Fondation Bettencourt Schueller.http://www.sciencedirect.com/science/article/pii/S2468266721002000 |
| spellingShingle | Olivier Aubert, MD Daniel Yoo, MPH Dina Zielinski, PhD Emanuele Cozzi, MD Massimo Cardillo, MD Michael Dürr, MD Beatriz Domínguez-Gil, MD Elisabeth Coll, MD Margarida Ivo Da Silva, MD Ville Sallinen, MD Karl Lemström, MD Karsten Midtvedt, MD Camilo Ulloa, MD Franz Immer, MD Annemarie Weissenbacher, MD Natalie Vallant, MD Nikolina Basic-Jukic, MD Kazunari Tanabe, MD Georgios Papatheodoridis, PhD Georgia Menoudakou, MSc Martin Torres, MD Carlos Soratti, MD Daniela Hansen Krogh Carmen Lefaucheur, MD Gustavo Ferreira, MD Helio Tedesco Silva, Jr, MD David Hartell, MA John Forsythe, MD Lisa Mumford, MSc Peter P Reese, MD François Kerbaul, MD Christian Jacquelinet, MD Serge Vogelaar, MD Vassilios Papalois, MD Alexandre Loupy, MD COVID-19 pandemic and worldwide organ transplantation: a population-based study The Lancet Public Health |
| title | COVID-19 pandemic and worldwide organ transplantation: a population-based study |
| title_full | COVID-19 pandemic and worldwide organ transplantation: a population-based study |
| title_fullStr | COVID-19 pandemic and worldwide organ transplantation: a population-based study |
| title_full_unstemmed | COVID-19 pandemic and worldwide organ transplantation: a population-based study |
| title_short | COVID-19 pandemic and worldwide organ transplantation: a population-based study |
| title_sort | covid 19 pandemic and worldwide organ transplantation a population based study |
| url | http://www.sciencedirect.com/science/article/pii/S2468266721002000 |
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