Solid Organ Transplantation During COVID-19 Pandemic: An International Web-based Survey on Resources’ Allocation
(2021) In Transplantation direct 7(3).- Abstract
- Background.
Solid organ transplants (SOTs) are life-saving interventions, recently challenged by coronavirus disease 2019 (COVID-19). SOTs require a multistep process, which can be affected by COVID-19 at several phases.
Methods.
SOT-specialists, COVID-19-specialists, and medical ethicists designed an international survey according to CHERRIES guidelines. Personal opinions about continuing SOTs, safe managing of donors and recipients, as well as equity of resources’ allocation were investigated. The survey was sent by e-mail. Multiple approaches were used (corresponding authors from Scopus, websites of scientific societies, COVID-19 webinars). After the descriptive analysis, univariate and multivariate ordinal... (More) - Background.
Solid organ transplants (SOTs) are life-saving interventions, recently challenged by coronavirus disease 2019 (COVID-19). SOTs require a multistep process, which can be affected by COVID-19 at several phases.
Methods.
SOT-specialists, COVID-19-specialists, and medical ethicists designed an international survey according to CHERRIES guidelines. Personal opinions about continuing SOTs, safe managing of donors and recipients, as well as equity of resources’ allocation were investigated. The survey was sent by e-mail. Multiple approaches were used (corresponding authors from Scopus, websites of scientific societies, COVID-19 webinars). After the descriptive analysis, univariate and multivariate ordinal regression analysis was performed.
Results.
There were 1819 complete answers from 71 countries. The response rate was 49%. Data were stratified according to region, macrospecialty, and organ of interest. Answers were analyzed using univariate-multivariate ordinal regression analysis and thematic analysis. Overall, 20% of the responders thought SOTs should not stop (continue transplant without restriction); over 70% suggested SOTs should selectively stop, and almost 10% indicated they should completely stop. Furthermore, 82% agreed to shift resources from transplant to COVID-19 temporarily. Briefly, main reason for not stopping was that if the transplant will not proceed, the organ will be wasted. Focusing on SOT from living donors, 61% stated that activity should be restricted only to “urgent” cases. At the multivariate analysis, factors identified in favor of continuing transplant were Italy, ethicist, partially disagreeing on the equity question, a high number of COVID-19-related deaths on the day of the answer, a high IHDI country. Factors predicting to stop SOTs were Europe except-Italy, public university hospital, and strongly agreeing on the equity question.
Conclusions.
In conclusion, the majority of responders suggested that transplant activity should be continued through the implementation of isolation measures and the adoption of the COVID-19-free pathways. Differences between professional categories are less strong than supposed.
(Less)
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- author
- Giovinazzo, Francesco ; Avolio, Alfonso W. ; Galiandro, Federica ; Vitale, Alessandro ; Dalla Riva, Giulio V. ; Biancofiore, Gianni ; Sharma, Shivani ; Muiesan, Paolo ; Agnes, Salvatore and Burra, Patrizia
- contributor
- Nilsson, Johan
LU
- author collaboration
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Transplantation direct
- volume
- 7
- issue
- 3
- article number
- e669
- publisher
- Wolters Kluwer
- external identifiers
-
- scopus:85104308801
- pmid:34113712
- ISSN
- 2373-8731
- DOI
- 10.1097/TXD.0000000000001115
- language
- English
- LU publication?
- yes
- id
- b5331e5e-0db7-4dce-a0d4-33706cc02f55
- date added to LUP
- 2021-02-25 08:00:08
- date last changed
- 2022-07-06 05:48:56
@article{b5331e5e-0db7-4dce-a0d4-33706cc02f55,
abstract = {{Background. <br/><br/>Solid organ transplants (SOTs) are life-saving interventions, recently challenged by coronavirus disease 2019 (COVID-19). SOTs require a multistep process, which can be affected by COVID-19 at several phases.<br/>Methods. <br/><br/>SOT-specialists, COVID-19-specialists, and medical ethicists designed an international survey according to CHERRIES guidelines. Personal opinions about continuing SOTs, safe managing of donors and recipients, as well as equity of resources’ allocation were investigated. The survey was sent by e-mail. Multiple approaches were used (corresponding authors from Scopus, websites of scientific societies, COVID-19 webinars). After the descriptive analysis, univariate and multivariate ordinal regression analysis was performed.<br/>Results. <br/><br/>There were 1819 complete answers from 71 countries. The response rate was 49%. Data were stratified according to region, macrospecialty, and organ of interest. Answers were analyzed using univariate-multivariate ordinal regression analysis and thematic analysis. Overall, 20% of the responders thought SOTs should not stop (continue transplant without restriction); over 70% suggested SOTs should selectively stop, and almost 10% indicated they should completely stop. Furthermore, 82% agreed to shift resources from transplant to COVID-19 temporarily. Briefly, main reason for not stopping was that if the transplant will not proceed, the organ will be wasted. Focusing on SOT from living donors, 61% stated that activity should be restricted only to “urgent” cases. At the multivariate analysis, factors identified in favor of continuing transplant were Italy, ethicist, partially disagreeing on the equity question, a high number of COVID-19-related deaths on the day of the answer, a high IHDI country. Factors predicting to stop SOTs were Europe except-Italy, public university hospital, and strongly agreeing on the equity question.<br/>Conclusions. <br/><br/>In conclusion, the majority of responders suggested that transplant activity should be continued through the implementation of isolation measures and the adoption of the COVID-19-free pathways. Differences between professional categories are less strong than supposed.<br/>}},
author = {{Giovinazzo, Francesco and Avolio, Alfonso W. and Galiandro, Federica and Vitale, Alessandro and Dalla Riva, Giulio V. and Biancofiore, Gianni and Sharma, Shivani and Muiesan, Paolo and Agnes, Salvatore and Burra, Patrizia}},
issn = {{2373-8731}},
language = {{eng}},
number = {{3}},
publisher = {{Wolters Kluwer}},
series = {{Transplantation direct}},
title = {{Solid Organ Transplantation During COVID-19 Pandemic: An International Web-based Survey on Resources’ Allocation}},
url = {{http://dx.doi.org/10.1097/TXD.0000000000001115}},
doi = {{10.1097/TXD.0000000000001115}},
volume = {{7}},
year = {{2021}},
}