测量 COVID-19 大流行对实体器官移植的影响。

Measuring the effect of the COVID-19 pandemic on solid organ transplantation.

机构信息

Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.

出版信息

Am J Surg. 2022 Jul;224(1 Pt B):437-442. doi: 10.1016/j.amjsurg.2021.12.036. Epub 2021 Dec 30.

DOI:10.1016/j.amjsurg.2021.12.036

PMID:34980465

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8717917/

Abstract

BACKGROUND

The COVID-19 pandemic has uniquely affected the United States. We hypothesize that transplantation would be uniquely affected.

METHODS

In this population-based cohort study, adult transplantation data were examined as time series data. Autoregressive-integrated-moving-average models of transplantation rates were developed using data from 1990 to 2019 to forecast the 2020 expected rates in a theoretical scenario if the pandemic did not occur to generate observed-to-expected (O/E) ratios.

RESULTS

32,594 transplants were expected in 2020, and only 30,566 occurred (O/E 0.94, CI 0.88-0.99). 58,152 waitlist registrations were expected and 50,241 occurred (O/E 0.86, CI 0.80-0.94). O/E ratios of transplants were kidney 0.92 (0.86-0.98), liver 0.96 (0.89-1.04), heart 1.05 (0.91-1.23), and lung 0.92 (0.82-1.04). O/E ratios of registrations were kidney 0.84 (0.77-0.93), liver 0.95 (0.86-1.06), heart 0.99 (0.85-1.18), and lung 0.80 (0.70-0.94).

CONCLUSIONS

The COVID-19 pandemic was associated with a significant deficit in transplantation. The impact was strongest in kidney transplantation and waitlist registration.

摘要

背景

COVID-19 大流行对美国产生了独特的影响。我们假设移植也会受到独特的影响。

方法

在这项基于人群的队列研究中，将成人移植数据作为时间序列数据进行检查。使用 1990 年至 2019 年的数据，建立了移植率的自回归积分移动平均模型，以预测在假设没有大流行的情况下，2020 年的预期比率，以生成观察到的预期（O/E）比率。

结果

预计 2020 年将进行 32594 次移植，但实际仅进行了 30566 次（O/E 0.94，CI 0.88-0.99）。预计有 58152 个等待名单登记，但实际有 50241 个（O/E 0.86，CI 0.80-0.94）。移植的 O/E 比率为肾脏 0.92（0.86-0.98）、肝脏 0.96（0.89-1.04）、心脏 1.05（0.91-1.23）和肺 0.92（0.82-1.04）。登记的 O/E 比率为肾脏 0.84（0.77-0.93）、肝脏 0.95（0.86-1.06）、心脏 0.99（0.85-1.18）和肺 0.80（0.70-0.94）。