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应对 COVID-19 大流行:美国器官获取与移植网络的初步影响和应对措施。

Navigating the COVID-19 pandemic: Initial impacts and responses of the Organ Procurement and Transplantation Network in the United States.

机构信息

Research Department, United Network for Organ Sharing, Richmond, VA, USA.

Contract Operations, United Network for Organ Sharing, Richmond, VA, USA.

出版信息

Am J Transplant. 2021 Jun;21(6):2100-2112. doi: 10.1111/ajt.16411. Epub 2020 Dec 16.

Abstract

COVID-19 has been sweeping the globe, hitting the United States particularly hard with a state of emergency declared on March 13, 2020. Transplant hospitals have taken various precautions to protect patients from potential exposure. OPTN donor, candidate, and transplant data were analyzed from January 5, 2020 to September 5, 2020. The number of new waiting list registrations decreased, with the Northeast seeing over a 50% decrease from the week of 3/8 versus the week of 4/5. The national transplant system saw near cessation of living donor transplantation (-90%) from the week of 3/8 to the week of 4/5. Similarly, deceased donor kidney transplant volume dropped from 367 to 202 (-45%), and other organs saw similar decreases: lung (-70%), heart (-43%), and liver (-37%). Deceased donors recovered dropped from 260 to 163 (-45%) from 3/8 compared to 4/5, including a 67% decrease for lungs recovered. The magnitude of this decrease varied by geographic area, with the largest percent change (-67%) in the Northeast. Despite the pandemic, discard rates across organ has remained stable. Although the COVID-19 pandemic continues to evolve, OPTN data show recent evidence of stabilization, an indication that an early recovery of the number of living and deceased donors and transplants has ensued.

摘要

新冠疫情在全球肆虐,美国受到的冲击尤为严重,该国于 2020 年 3 月 13 日宣布进入紧急状态。移植医院已采取各种预防措施,以保护患者免受潜在感染。从 2020 年 1 月 5 日至 9 月 5 日,对 OPTN 供体、候选人和移植数据进行了分析。新的候补名单登记数量有所减少,与 3 月 8 日当周相比,东北部的登记数量下降了超过 50%。从 3 月 8 日当周至 4 月 5 日当周,全国活体供者移植几乎停止(减少 90%)。同样,从 367 例降至 202 例,死亡供者的肾脏移植量下降(减少 45%),其他器官也出现类似下降:肺(减少 70%)、心脏(减少 43%)和肝脏(减少 37%)。从 3 月 8 日到 4 月 5 日,死亡供者的恢复数量从 260 例降至 163 例(减少 45%),其中肺部恢复数量减少了 67%。这种下降的幅度因地理区域而异,东北部的降幅最大(减少 67%)。尽管发生了大流行,但各器官的废弃率仍保持稳定。尽管 COVID-19 疫情仍在继续演变,但 OPTN 数据显示最近出现了稳定的迹象,这表明活体供者和死亡供者以及移植的数量已经开始恢复。

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