Decreased access to pediatric liver transplantation during the COVID-19 pandemic.
Pediatr Transplant
; 26(2): e14162, 2022 03.
Article
in English
| MEDLINE | ID: covidwho-1462869
ABSTRACT
BACKGROUND:
The COVID-19 pandemic has affected all aspects of the US healthcare system, including liver transplantation. The objective of this study was to understand national changes to pediatric liver transplantation during COVID-19.METHODS:
Using SRTR data, we compared waitlist additions, removals, and liver transplantations for pre-COVID-19 (March-November 2016-2019), early COVID-19 (March-May 2020), and late COVID-19 (June-November 2020).RESULTS:
Waitlist additions decreased by 25% during early COVID-19 (41.3/month vs. 55.4/month, p < .001) with black candidates most affected (p = .04). Children spent longer on the waitlist during early COVID-19 compared to pre-COVID-19 (140 vs. 96 days, p < .001). There was a 38% decrease in liver transplantations during early COVID-19 (IRR 0.62, 95% CI 0.49-0.78), recovering to pre-pandemic rates during late COVID-19 (IRR 1.03, NS), and no change in percentage of living and deceased donors. White children had a 30% decrease in overall liver transplantation but no change in living donor liver transplantation (IRR 0.7, 95% CI 0.50-0.95; IRR 0.96, NS), while non-white children had a 44% decrease in overall liver transplantation (IRR 0.56, 95% CI 0.40-0.77) and 81% decrease in living donor liver transplantation (IRR 0.19, 95% CI 0.02-0.76).CONCLUSIONS:
The COVID-19 pandemic decreased access to pediatric liver transplantation, particularly in its early stage. There were no regional differences in liver transplantation during COVID-19 despite the increased national sharing of organs. While pediatric liver transplantation has resumed pre-pandemic levels, ongoing racial disparities must be addressed.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Waiting Lists
/
Liver Transplantation
/
Healthcare Disparities
/
COVID-19
/
Health Services Accessibility
Type of study:
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Infant, Newborn
Country/Region as subject:
North America
Language:
English
Journal:
Pediatr Transplant
Journal subject:
Pediatrics
/
Transplantation
Year:
2022
Document Type:
Article
Affiliation country:
Petr.14162
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