Early national and center‐level changes to kidney transplantation in the United States during the COVID‐19 epidemic. Issue 11 (5th August 2020)

• Record Type: Journal Article
• Authors: Boyarsky, Brian J.; Werbel, William A.; Durand, Christine M.; Avery, Robin K.; Jackson, Kyle R.; Kernodle, Amber B.; Snyder, Jon; Hirose, Ryutaro; Massie, Indraneel M.; Garonzik‐Wang, Jacqueline M.; Segev, Dorry L.; Massie, Allan B.
• Is Part Of: American journal of transplantation. Volume 20:Issue 11(2020)
• Page Start: 3131
• Page End: 3139
• Publication Date: 2020-08-05
• Subjects: clinical research/practice -- donors and donation: deceased -- donors and donation: living -- health services and outcomes research -- infection and infectious agents – viral -- infectious disease -- kidney transplantation/nephrology -- organ transplantation in general -- patient survival -- registry/registry analysis; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.16167
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : In March 2020, coronavirus disease 2019 (COVID‐19) spread rapidly nationally, causing widespread emergent changes to the health system. Our goal was to understand the impact of the epidemic on kidney transplantation (KT), at both the national and center levels, accounting statistically for waitlist composition. Using Scientific Registry of Transplant Recipients data, we compared data on observed waitlist registrations, waitlist mortality, and living‐donor and deceased‐donor kidney transplants (LDKT/DDKT) March 15‐April 30, 2020 to expected events calculated from preepidemic data January 2016‐February 2020. There were few changes before March 15, at which point the number of new listings/DDKT/LDKT dropped to 18%/24%/87% below the expected value (all P < .001). Only 12 centers performed LDKT March 15‐31; by April 30, 40 centers had resumed LDKT. The decline in new listings and DDKT was greater among states with higher per capita confirmed COVID‐19 cases. The number of waitlist deaths was 2.2‐fold higher than expected in the 5 states with highest COVID‐19 burden ( P < .001). DCD DDKT and regional/national imports declined nationwide but most steeply in states with the highest COVID‐19 burden. The COVID‐19 epidemic has resulted in substantial changes to KT; we must adapt and learn rapidly to continue to provide safe access to transplantation and limit the growing indirect toll of an already deadly disease. Abstract : The authors present national‐ and center‐level data on reduced kidney transplant activity early in the COVID‐19 pandemic and link findings to state‐level COVID‐19 burden.