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Solid Organ Transplantation During COVID-19 Pandemic: An International Web-based Survey on Resources’ Allocation

Giovinazzo, Francesco (författare)
Policlinico Universitario Agostino Gemelli
Avolio, Alfonso W. (författare)
Policlinico Universitario Agostino Gemelli,Catholic University of the Sacred Heart
Galiandro, Federica (författare)
Policlinico Universitario Agostino Gemelli
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Vitale, Alessandro (författare)
University Hospital of Padua
Dalla Riva, Giulio V. (författare)
Canterbury University
Biancofiore, Gianni (författare)
University of Pisa
Sharma, Shivani (författare)
University of Hertfordshire
Muiesan, Paolo (författare)
University Hospitals Birmingham
Agnes, Salvatore (författare)
Policlinico Universitario Agostino Gemelli,Catholic University of the Sacred Heart
Burra, Patrizia (författare)
University Hospital of Padua
Nilsson, Johan (creator_code:cre_t)
Lund University,Lunds universitet,Thoraxkirurgi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Hjärt- och lungtransplantation,Forskargrupper vid Lunds universitet,Thoracic Surgery,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Heart and Lung transplantation,Lund University Research Groups
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Wolters Kluwer Health, 2021
Ingår i: Transplantation direct. - : Wolters Kluwer Health. - 2373-8731. ; 7:3
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
  • 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.


MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

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