Yadav Anju, Singh Pooja
Division of Nephrology, Thomas Jefferson University Hospital, 833 Chestnut St, Suite 700, Philadelphia, PA USA.
Curr Transplant Rep. 2021;8(4):257-262. doi: 10.1007/s40472-021-00339-w. Epub 2021 Nov 17.
COVID-19 pandemic led to a decline in living kidney donor evaluations and transplants. This was due to concerns for donor and recipient safety, restrictions on elective cases, and diversion of staff and resources in centers with a higher incidence of COVID-19 infections. Telehealth was explored as a strategy to continue living donor evaluations during the pandemic, but faced barriers including restrictive physician licensing, reduced reimbursement, lack of infrastructure, prohibitive local policies, limited exam, and personal biases. This review highlights these barriers and potential solutions.
Telehealth usage in the transplant population improves medication adherence, reduces hospitalization rates for recipients, and makes living donor evaluation convenient. Transplant centers have implemented telehealth successfully for living kidney donor evaluations. Broad use of telemedicine will be possible only if policies support the changing landscape of healthcare delivery.
Telehealth may increase access to timely kidney transplants by expediting living kidney donor evaluations. However, supportive infrastructure, regulatory policies, and reimbursement are needed to sustain access to telehealth for living kidney donor evaluation and care.
新冠疫情导致活体肾供体评估和移植数量下降。这是由于对供体和受体安全的担忧、对择期病例的限制以及新冠感染发病率较高的中心人员和资源的转移。远程医疗被作为疫情期间继续进行活体供体评估的一种策略进行探索,但面临诸多障碍,包括医生执照限制、报销减少、缺乏基础设施、当地政策禁止、检查受限以及个人偏见。本综述强调了这些障碍和潜在解决方案。
移植人群中使用远程医疗可提高用药依从性,降低受体住院率,并使活体供体评估变得便捷。移植中心已成功将远程医疗用于活体肾供体评估。只有政策支持医疗服务提供方式的不断变化,远程医疗的广泛应用才有可能实现。
远程医疗可能通过加快活体肾供体评估来增加及时进行肾移植的机会。然而,需要支持性的基础设施、监管政策和报销来维持远程医疗用于活体肾供体评估和护理的可及性。