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1.
European journal of public health ; 32(Suppl 3), 2022.
Article in English | EuropePMC | ID: covidwho-2101672

ABSTRACT

Background The COVID-19 pandemic has resulted in worldwide kidney transplantation (KT) moratoriums. The impacts of these moratoriums on the life expectancy of KT candidates remain unclear. Methods We simulated the evolution of several French candidate populations for KT using a multistate semi-Markovian approach and according to moratorium durations ranging from 0 to 24 months. The transition rates were modeled from the 63,927 French patients who began dialysis or were registered on the waiting list for KT between 2011 and 2019. Results Among the 8,350 patients active on the waiting list at the time of the French KT moratorium decided on March 16, 2020, for 2.5-months, we predicted 4.0 additional months [CI: 2.8, 5.0] on the waiting list and 42 additional deaths [CI: -70, 150] up to March 16, 2030. In this population, we reported a significant impact for a 9-month moratorium duration: 135 attributable deaths [CI: 31, 257] up to March 16, 2030. Patients who became active on the list after March 2020 were less impacted. Interpretation The temporary moratorium of KT during a COVID-19 peak in order to free up hospitals’ resources doesn't impact patients’ 10-year survival if the moratorium does not exceed a prolonged period. Funding. French National Research Agency (ANR-20-COV8-0002-01). Key messages The French 2020 KT moratorium didn't impair patients’ 10-years survival. 9-month or longer moratoriums may impair patients’ 10-years survival.

2.
Néphrologie & Thérapeutique ; 18(5):367, 2022.
Article in English | ScienceDirect | ID: covidwho-2007987

ABSTRACT

Introduction La pandémie de COVID-19 a provoqué des suspensions de l’activité de greffe rénale à travers le monde. L’impact de ces suspensions sur l’espérance de vie des candidats à la greffe rénale n’est pas encore bien établi. Description Nous avons simulé l’évolution de plusieurs populations de candidats français à la greffe du rein par une approche semi-Markovienne multi-états, en prenant en compte des suspensions allant de 0 à 24 mois. Méthodes Chaque scénario a été simulé 1000 fois. Les probabilités de chaque transition ont été modélisées par des modèles de Cox multivariés construits à partir de 63,927 patients français ayant commencé une dialyse ou ayant été inscrits sur liste d’attente pour une transplantation rénale entre 2011 et 2019. Les caractéristiques des patients incidents ont été simulées à partir de modèles logistiques et linéaires construits sur la même population. Résultats Parmi les 8350 candidats actifs à la transplantation rénale le 16 mars 2020, date à laquelle une suspension de 2,5 mois a commencé en France, nous avons prédit une augmentation du temps sur liste d’attente de 4,0 mois [IC: 2,8, 5,0] et 42 [IC: −70, 150] décès supplémentaires jusqu’au 16 mars 2030. La surmortalité pour cette population est significative à partir de 9 mois de suspension: 135 décès supplémentaires [IC: 31, 257] jusqu’au 16 mars 2030. Les patients devenant candidats actifs après le 16 mars 2020 sont moins affectées par la suspension. Conclusion La suspension temporaire de l’activité de greffe rénale lors d’un pic de COVID-19 est une décision viable afin de libérer les ressources hospitalières, tant que sa durée n’excède pas une période prolongée.

3.
Journal of Liver Transplantation ; : 100051, 2021.
Article in English | ScienceDirect | ID: covidwho-1474864

ABSTRACT

The COVID-19 pandemic strongly affected organ procurement and transplantation in France, despite the intense efforts of all participants in this domain. In 2020, the identification and procurement of deceased donors fell by 12% and 21% respectively, compared with the mean of the preceding 2 years. Similarly, the number of new registrations on the national waiting list declined by 12% and the number of transplants by 24%. The 3-month cumulative incidence of death or drop out for worsening condition of patients awaiting a liver transplant was significantly greater in 2020 compared to the previous 2 years. Continuous monitoring at the national level of early post-transplant outcomes showed no deterioration for any organ in 2020. At the end of 2020, less than 1% of transplant candidates and less than 1% of graft recipients — of any organ — had died of COVID-19.

4.
Journal of Heart and Lung Transplantation ; 40(4):S18-S19, 2021.
Article in English | Web of Science | ID: covidwho-1187478
5.
Journal of Heart and Lung Transplantation ; 40(4):S143-S143, 2021.
Article in English | Web of Science | ID: covidwho-1187477
6.
Journal of Heart and Lung Transplantation ; 40(4):S314-S314, 2021.
Article in English | Web of Science | ID: covidwho-1187355
7.
Journal of Heart and Lung Transplantation ; 40(4):S20-S21, 2021.
Article in English | Web of Science | ID: covidwho-1187354
8.
The Journal of Heart and Lung Transplantation ; 40(4, Supplement):S314, 2021.
Article in English | ScienceDirect | ID: covidwho-1141811

ABSTRACT

Purpose The COVID-19 pandemic has deeply affected organ transplant activity across the world. While the Agence de la biomedecine in agreement with the French lung transplant community has limited the transplant program to patients with high-urgency status during the first epidemic wave, the program has been fully restored where possible during the second epidemic wave. This study aimed to examine the impact of COVID-19 on new listings, waitlist outcomes and transplant activity in France. Methods All patients newly registered on the national waiting list for lung transplantation between January and September 2018-2020 were included in the study (n=878). The numbers of new listings and transplants per million population (pmp) in 2018-2019 period and in 2020 COVID era were compared. Cumulative incidence of transplantation and waitlist mortality estimated with the competing risk analysis with transplantation and death or delisting for medical condition as the competing events were compared between the study periods. Results In 2020 compared with the 2018-2019 period, the total number of patients newly registered on the waiting list declined 34%, from 4.9 to 3.2 pmp and the number of transplants performed decreased 31%, from 3.9 to 2.6 pmp. While 3-month cumulative incidence of transplantation (Figure 1) decreased from 54% [51-58] to 46% [39-53], no difference in cumulative incidence of death or delisting for medical condition (3% [2-4] versus 4% [2-8]) (Figure 2) was observed between the periods. Conclusion In 2020 COVID era, the waitlist and transplant access significantly declined in France without change in waitlist mortality.

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