The COVID-19 Pandemic and Adult Cardiac Transplantation: Impact, Interventions, and Implications.
Can J Cardiol
; 39(6): 853-864, 2023 Jun.
Artículo
en Inglés
| MEDLINE | ID: covidwho-2254849
ABSTRACT
In this review, we provide a comprehensive overview of the impact of the COVID-19 pandemic on adult heart transplantation. We highlight the decline in the number of adult transplantations performed throughout the pandemic as a consequence of restrictions imposed on individual programs and hospitals. There were challenges to maintaining cardiac transplant activity at multiple levels, including organ donation in intensive care units, logistical difficulties with organ procurement, and rapidly changing resource considerations at health system and jurisdictional levels. We also review the impact of COVID-19 on cardiac transplant recipients. Despite the high rates of morbidity and mortality observed during the initial phases of the pandemic among heart transplant patients infected with COVID-19, the availability of effective vaccines, pre-exposure prophylaxis, and specific antiviral therapies have drastically improved outcomes over time. Vaccines have proven to be safe and effective in reducing infections and illness severity, but specific considerations in the immunocompromised solid organ transplant population apply, including the need for additional booster doses to achieve sufficient immunisation. We further outline the strong rationale for vaccination before transplantation wherever possible. Finally, the COVID-19 response created a number of barriers to safe and efficient post-transplantation care. Given the need for frequent evaluation and monitoring, especially in the first several months after cardiac transplantation, the pandemic provided the impetus to improve virtual care delivery and explore noninvasive rejection surveillance through gene expression profiling. We hope that lessons learned will allow us to prepare and pivot effectively during future pandemics and health care emergencies.
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Vacunas
/
Trasplante de Órganos
/
Trasplante de Corazón
/
COVID-19
Tipo de estudio:
Estudio experimental
/
Estudio observacional
/
Estudio pronóstico
Tópicos:
Vacunas
Límite:
Adulto
/
Humanos
Idioma:
Inglés
Revista:
Can J Cardiol
Asunto de la revista:
Cardiología
Año:
2023
Tipo del documento:
Artículo
País de afiliación:
J.cjca.2023.03.014
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