Patient Access to Liver Transplantation Unaffected by COVID-19 Pandemic

liver transplant, surgery
Investigators evaluated the COVID-19 pandemic’s impact on patient access to liver transplantation.

The coronavirus disease 2019 (COVID-19) pandemic was not found to affect patient access to liver transplantation, according to findings from a study presented at The Liver Meeting Digital Experience, hosted by the American Association for the Study of Liver Disease.  

The investigators used the United Network for Organ Sharing (UNOS) database to identify all adults who received a solid organ transplant (liver, kidney, heart, or lung) between February 2020 and June 2020. From the database, the study authors extracted patient information on recipient demographics and UNOS regions. Chi‐square and analysis of variance (ANOVA) tests were used for comparative analysis. The analysis included only Caucasian, Black, Hispanic, and Asian individuals who underwent transplant “due to the small proportion of other ethnicities,” according to the study authors.

A total of 14,741 patients received a solid organ transplant during the study period. Of them, 3420 recipients underwent transplant pre-pandemic (February 2020). The remaining 11,321 patients received their respective transplants during the COVID-19 period, defined as March 2020 to June 2020

The peak COVID-19 period was April 2020, according to the study authors. During this peak period, there was a 38% reduction in solid organ transplants. The greatest decline was seen in those who received a kidney transplant (44.7%), followed by decreases observed in patients who pursued lung (41.3%), heart (27.2%), and liver transplants (23.4%).

Among patients who had a liver transplant, “a significant decline was only observed in 3 geographic locations… but no significant ethnic variation was observed,” the investigators said. COVID-19 has been known to disproportionately affect ethnic minorities and some geographic areas of the United States. Further, ethnic and regional variation have historically affected patient access to liver transplantation, providing the researchers’ rationale to assess the COVID-19 pandemic’s impact on this intervention.

“The observed regional variation in liver transplantation correlated with the COVID[-19] hotspots,” the researchers concluded. “Despite the reports of disproportionate impact of COVID[-19] on ethnic minorities in the US population, our study showed no impact among liver transplantation recipients. Future and long‐term studies are needed to explore and better understand the association (dynamics) between COVID[-19] and social determinants of access to liver transplantation and liver transplantation outcomes.”

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Kemmer N, Agrawal S, Albers C, Malespin M, Muhammad A, Syed R. Access to liver transplantation in COVID pandemic: role of ethnic and geographic dynamics. Poster presented at: The Liver Meeting Digital Experience; November 13-16, 2020. P409.