Chronological and Geographical Variations in the Incidence and Acceptance of COVID-19–Positive Donors and Outcomes Among Abdominal Transplant Patients

IF 1.9 4区医学 Q2 SURGERY Clinical Transplantation Pub Date : 2024-07-05 DOI:10.1111/ctr.15391

Jason Yang, Yutaka Endo, Kazunari Sasaki, Austin Schenk, Timothy M. Pawlik

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Abstract

Introduction

Given the importance of understanding COVID-19–positive donor incidence and acceptance, we characterize chronological and geographic variations in COVID-19 incidence relative to COVID-19–positive donor acceptance.

Methods

Data on deceased donors and recipients of liver and kidney transplants were obtained from the UNOS database between 2020 and 2023. Hierarchical cluster analysis was used to assess trends in COVID-19–positive donor incidence. Posttransplant graft and patient survival were assessed using Kaplan–Meier curves.

Results

From among 38 429 deceased donors, 1517 were COVID-19 positive. Fewer kidneys (72.4% vs. 76.5%, p < 0.001) and livers (56.4% vs. 62.0%, p < 0.001) were used from COVID-19–positive donors versus COVID-19–negative donors. Areas characterized by steadily increased COVID-19 donor incidence exhibit the highest transplantation acceptance rates (92.33%), followed by intermediate (84.62%) and rapidly increased (80.00%) COVID-19 incidence areas (p = 0.016). Posttransplant graft and patient survival was comparable among recipients, irrespective of donor COVID-19 status.

Conclusions

Regions experiencing heightened rates of COVID-19–positive donors are associated with decreased acceptance of liver and kidney transplantation. Similar graft and patient survival is noted among recipients, irrespective of donor COVID-19 status. These findings emphasize the need for adaptive practices and unified medical consensus in navigating a dynamic pandemic.

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腹腔移植患者中 COVID-19 阳性捐献者的发生率和接受率及结果的年代和地域差异。

简介：鉴于了解 COVID-19 阳性捐献者发生率和接受率的重要性，我们描述了 COVID-19 发生率与 COVID-19 阳性捐献者接受率之间的时间和地理差异：我们从 UNOS 数据库中获取了 2020 年至 2023 年间已故肝肾移植供体和受体的数据。采用层次聚类分析评估COVID-19阳性供体发生率的趋势。使用 Kaplan-Meier 曲线评估移植后移植物和患者的存活率：在38 429名已故捐献者中，有1517名COVID-19阳性。与 COVID-19 阴性供体相比，COVID-19 阳性供体使用的肾脏（72.4% 对 76.5%，P < 0.001）和肝脏（56.4% 对 62.0%，P < 0.001）更少。COVID-19供体发生率稳步上升的地区的移植接受率最高（92.33%），其次是COVID-19发生率居中的地区（84.62%）和快速上升的地区（80.00%）（p = 0.016）。无论供体的COVID-19状况如何，移植后受体和患者的存活率相当：结论：COVID-19 阳性捐献者比例增加的地区与肝脏和肾脏移植接受率下降有关。无论供体COVID-19状态如何，受体的移植物存活率和患者存活率相似。这些发现强调，在应对动态流行病时，需要有适应性的做法和统一的医学共识。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.