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SARS-CoV-2 大流行和 COVID-19 对英国肺移植的影响:第一波疫情中吸取的经验教训。

The impact of the SARS-CoV-2 pandemic and COVID-19 on lung transplantation in the UK: Lessons learned from the first wave.

机构信息

Clinical Research and Clinical Audit Fellow in Cardiothoracic Transplantation, NHS Blood and Transplant, Bristol, UK.

Institute of Transplantation, Freeman Hospital, Newcastle upon Tyne, UK.

出版信息

Clin Transplant. 2021 Mar;35(3):e14210. doi: 10.1111/ctr.14210. Epub 2021 Feb 1.

Abstract

BACKGROUND

Lung transplantation is particularly susceptible to the impact of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, and evaluation of changes to practice is required to inform future decision-making.

METHODS

A retrospective review of the UK Transplant Registry (UKTR) and national survey of UK lung transplant centers has been performed.

RESULTS

There was geographic variation in the prevalence of COVID-19 infection across the UK. The number of donors fell by 48% during the early pandemic period. Lung utilization fell to 10% (compared with 24% for the same period of 2019). The number of lung transplants performed fell by 77% from 53, March to May 2019, to 12. Seven (58%) of these were performed in a single-center, designated "COVID-light." The number of patients who died on the lung transplant waiting list increased, compared to the same period of 2019 (p = .0118). Twenty-six lung transplant recipients with confirmed COVID-19 infection were reported during the study period.

CONCLUSION

As the pandemic continues, reviewing practice and implementing the lessons learned during this period, including the use of robust donor testing strategies and the provision of "COVID-light" hospitals, are vital in ensuring the safe continuation of our lung transplant program.

摘要

背景

肺移植特别容易受到严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)大流行的影响,需要评估实践中的变化,以为未来的决策提供信息。

方法

对英国移植登记处(UKTR)和英国肺移植中心的全国性调查进行了回顾性分析。

结果

英国各地 COVID-19 感染的流行程度存在地域差异。在大流行早期,供体数量下降了 48%。肺的利用率下降到 10%(而 2019 年同期为 24%)。肺移植数量从 2019 年 3 月至 5 月的 53 例下降了 77%,降至 12 例。其中 7 例(58%)在一个单一中心进行,被指定为“COVID-light”。与 2019 年同期相比,等待肺移植名单上死亡的患者人数增加(p = 0.0118)。在研究期间报告了 26 例确诊为 COVID-19 感染的肺移植受者。

结论

随着大流行的持续,审查实践并吸取这一时期的经验教训,包括使用强大的供体检测策略和提供“COVID-light”医院,对于确保我们的肺移植计划的安全继续进行至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13c0/7883175/e6ddfa5c26d1/CTR-35-0-g001.jpg

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