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Effects of COVID-19 pandemic on pediatric kidney transplant in the United States.
Charnaya, Olga; Chiang, Teresa Po-Yu; Wang, Richard; Motter, Jennifer D; Boyarsky, Brian J; King, Elizabeth A; Werbel, William A; Durand, Christine M; Avery, Robin K; Segev, Dorry L; Massie, Allan B; Garonzik-Wang, Jacqueline M.
  • Charnaya O; Department of Pediatrics, Johns Hopkins University School of Medicine, 200 N Wolfe St., Room 3055, Baltimore, MD, 21287, USA. ocharna1@jhmi.edu.
  • Chiang TP; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Wang R; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Motter JD; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Boyarsky BJ; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • King EA; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Werbel WA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Durand CM; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Avery RK; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Segev DL; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Massie AB; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA.
  • Garonzik-Wang JM; Scientific Registry of Transplant Recipients, Minneapolis, MN, USA.
Pediatr Nephrol ; 36(1): 143-151, 2021 01.
Article in English | MEDLINE | ID: covidwho-800908
Preprint
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ABSTRACT

BACKGROUND:

In March 2020, COVID-19 infections began to rise exponentially in the USA, placing substantial burden on the healthcare system. As a result, there was a rapid change in transplant practices and policies, with cessation of most procedures. Our goal was to understand changes to pediatric kidney transplantation (KT) at the national level during the COVID-19 epidemic.

METHODS:

Using SRTR data, we examined changes in pediatric waitlist registration, waitlist removal or inactivation, and deceased donor and living donor (DDKT/LDKT) events during the start of the disease transmission in the USA compared with the same time the previous year.

RESULTS:

We saw an initial decrease in DDKT and LDKT by 47% and 82% compared with expected events and then a continual increase, with numbers reaching expected prepandemic levels by May 2020. In the early phase of the pandemic, waitlist inactivation and removals due to death or deteriorating condition rose above expected values by 152% and 189%, respectively. There was a statistically significant decrease in new waitlist additions (IRR 0.49 0.65 0.85) and LDKT (IRR 0.17 0.38 0.84) in states with high vs. low COVID activity. Transplant recipients during the pandemic were more likely to have received a DDKT, but had similar calculated panel-reactive antibody (cPRA) values, waitlist time, and cause of kidney failure as before the pandemic.

CONCLUSIONS:

The COVID-19 pandemic initially reduced access to kidney transplantation among pediatric patients in the USA but has not had a sustained effect.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Waiting Lists / Kidney Transplantation / Living Donors Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged / Infant, Newborn Country/Region as subject: North America Language: English Journal: Pediatr Nephrol Journal subject: Nephrology / Pediatrics Year: 2021 Document Type: Article Affiliation country: S00467-020-04764-4

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Waiting Lists / Kidney Transplantation / Living Donors Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged / Infant, Newborn Country/Region as subject: North America Language: English Journal: Pediatr Nephrol Journal subject: Nephrology / Pediatrics Year: 2021 Document Type: Article Affiliation country: S00467-020-04764-4