A coordinated national UK liver transplant program response, prioritizing waitlist recipients with the highest need, provided excellent outcomes during the first wave of the COVID-19 pandemic.
Clin Transplant
; 36(4): e14563, 2022 04.
Article
in English
| MEDLINE | ID: covidwho-1612858
ABSTRACT
INTRODUCTION:
Healthcare provision has been severely affected by COVID-19, with specific challenges in organ transplantation. Here, we describe the coordinated response to, and outcomes during the first wave, across all UK liver transplant (LT) centers.METHODS:
Several policy changes affecting the liver transplant processes were agreed upon. These included donor age restrictions and changes to offering. A "high-urgency" (HU) category was established, prioritizing only those with UKELD > 60, HCC reaching transplant criteria, and others likely to die within 90 days. Outcomes were compared with the same period in 2018 and 2019.RESULTS:
The retrieval rate for deceased donor livers (71% vs. 54%; P < .0001) and conversion from offer to completed transplant (63% vs. 48%; P < .0001) was significantly higher. Pediatric LT activity was maintained; there was a significant reduction in adult (42%) and total (36%) LT. Almost all adult LT were super-urgent (n = 15) or HU (n = 133). We successfully prioritized those with highest illness severity with no reduction in 90-day patient (P = .89) or graft survival (P = .98). There was a small (5% compared with 3%; P = .0015) increase in deaths or removals from the waitlist, mainly amongst HU cohort.CONCLUSIONS:
We successfully prioritized LT recipients in highest need, maintaining excellent outcomes, and waitlist mortality was only marginally increased.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Liver Transplantation
/
Carcinoma, Hepatocellular
/
COVID-19
/
Liver Neoplasms
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Adult
/
Child
/
Humans
Country/Region as subject:
Europa
Language:
English
Journal:
Clin Transplant
Journal subject:
Transplantation
Year:
2022
Document Type:
Article
Affiliation country:
Ctr.14563
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