COVID-19 pandemic and worldwide organ transplantation: a population-based study.

COVID-19 / epidemiology Global Health / statistics & numerical data Humans Organ Transplantation / statistics & numerical data Pandemics

Journal

The Lancet. Public health
ISSN: 2468-2667
Titre abrégé: Lancet Public Health
Pays: England
ID NLM: 101699003

Informations de publication

Date de publication:
10 2021
Historique:
received: 09 05 2021
revised: 02 08 2021
accepted: 16 08 2021
pubmed: 3 9 2021
medline: 2 10 2021
entrez: 2 9 2021
Statut: ppublish

Résumé

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. 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. 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. 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. French national research agency (INSERM) ATIP Avenir and Fondation Bettencourt Schueller.

Sections du résumé

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.

Identifiants

DOI: 10.1016/S2468-2667(21)00200-0 PMID: 34474014 PMC: PMC8460176
pubmed: 34474014
pii: S2468-2667(21)00200-0
doi: 10.1016/S2468-2667(21)00200-0
pmc: PMC8460176
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT04416256']

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e709-e719

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of interests We declare no competing interests.

Auteurs

Olivier Aubert (O)

Université 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.

Daniel Yoo (D)

Université de Paris, INSERM, PARCC, Paris Translational Research Centre for Organ Transplantation, Paris, France.

Dina Zielinski (D)

Université de Paris, INSERM, PARCC, Paris Translational Research Centre for Organ Transplantation, Paris, France.

Emanuele Cozzi (E)

Transplant 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, Italy.

Massimo Cardillo (M)

Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy.

Michael Dürr (M)

Division of Nephrology and Internal Intensive Care Medicine, Charité-Universitätsmedizin, Berlin, Germany.

Beatriz Domínguez-Gil (B)

Organización Nacional de Transplantes, Madrid, Spain.

Elisabeth Coll (E)

Organización Nacional de Transplantes, Madrid, Spain.

Margarida Ivo Da Silva (MI)

Instituo portuges de sangue e da transplantacao, Lisbon, Portugal.

Ville Sallinen (V)

Department of Transplantation and Liver Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Karl Lemström (K)

Department of Cardiothoracic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Karsten Midtvedt (K)

Department of Transplant Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

Camilo Ulloa (C)

Nephrology Department, Clínica Alemana de Santiago-UDD, Santiago, Chile.

Franz Immer (F)

Swisstransplant, Bern, Switzerland.

Annemarie Weissenbacher (A)

Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Medical University of Innsbruck, Innsbruck, Austria.

Natalie Vallant (N)

Department of Transplant Surgery, Faculty of Medicine, Imperial College London, London, UK.

Nikolina Basic-Jukic (N)

Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia.

Kazunari Tanabe (K)

Department of Urology, Tokyo Women's Medical University, Tokyo, Japan.

Georgios Papatheodoridis (G)

Hellenic Transplant Organization, Athens, Greece.

Georgia Menoudakou (G)

Hellenic Transplant Organization, Athens, Greece.

Martin Torres (M)

Instituto Nacional Central Único Coordinador de Ablación e Implante (INCUCAI), Buenos Aires, Argentina.

Carlos Soratti (C)

Instituto Nacional Central Único Coordinador de Ablación e Implante (INCUCAI), Buenos Aires, Argentina.

Daniela Hansen Krogh (D)

Instituto Nacional Central Único Coordinador de Ablación e Implante (INCUCAI), Buenos Aires, Argentina.

Carmen Lefaucheur (C)

Université 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, France.

Gustavo Ferreira (G)

Department of Medicine, Santa Casa de Juiz de Fora, Juiz de Fora, Brazil.

Helio Tedesco Silva (HT)

Division of Nephrology, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil.

David Hartell (D)

Canadian Blood Services, Ottawa, ON, Canada.

John Forsythe (J)

NHS Blood and Transplant, Stoke Gifford, Bristol, UK.

Lisa Mumford (L)

Statistics and Clinical Studies, NHS Blood and Transplant, Bristol, UK.

Peter P Reese (PP)

Université 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, USA.

François Kerbaul (F)

Agence de la Biomédecine, Saint Denis la Plaine, France.

Christian Jacquelinet (C)

Agence de la Biomédecine, Saint Denis la Plaine, France.

Serge Vogelaar (S)

Eurotransplant International Foundation, Leiden, Netherlands.

Vassilios Papalois (V)

Department of Surgery, Faculty of Medicine, Imperial College London, London, UK.

Alexandre Loupy (A)

Université 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. Electronic address: alexandre.loupy@inserm.fr.

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Classifications MeSH

questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › COVID-19 › COVID-19 pandemic and worldwide organ...
questionsmedicales.fr › Caractéristiques de la population › Santé › Santé mondiale › COVID-19 pandemic and worldwide organ...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › COVID-19 pandemic and worldwide organ...
questionsmedicales.fr › Procédures de chirurgie opératoire › Transplantation › Transplantation d'organe › COVID-19 pandemic and worldwide organ...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Épidémies de maladies › Épidémies › Pandémies › COVID-19 pandemic and worldwide organ...