TY - JOUR
T1 - Effects of COVID-19 pandemic on pediatric kidney transplant in the United States
AU - Charnaya, Olga
AU - Chiang, Teresa Po Yu
AU - Wang, Richard
AU - Motter, Jennifer D.
AU - Boyarsky, Brian J.
AU - King, Elizabeth A.
AU - Werbel, William A.
AU - Durand, Christine M.
AU - Avery, Robin K.
AU - Segev, Dorry L.
AU - Massie, Allan B.
AU - Garonzik-Wang, Jacqueline M.
N1 - Publisher Copyright:
© 2020, IPNA.
PY - 2021/1
Y1 - 2021/1
N2 - Background: In March 2020, COVID-19 infections began to rise exponentially in the USA, placing substantial burden on the healthcare system. As a result, there was a rapid change in transplant practices and policies, with cessation of most procedures. Our goal was to understand changes to pediatric kidney transplantation (KT) at the national level during the COVID-19 epidemic. Methods: Using SRTR data, we examined changes in pediatric waitlist registration, waitlist removal or inactivation, and deceased donor and living donor (DDKT/LDKT) events during the start of the disease transmission in the USA compared with the same time the previous year. Results: We saw an initial decrease in DDKT and LDKT by 47% and 82% compared with expected events and then a continual increase, with numbers reaching expected prepandemic levels by May 2020. In the early phase of the pandemic, waitlist inactivation and removals due to death or deteriorating condition rose above expected values by 152% and 189%, respectively. There was a statistically significant decrease in new waitlist additions (IRR 0.49 0.65 0.85) and LDKT (IRR 0.17 0.38 0.84) in states with high vs. low COVID activity. Transplant recipients during the pandemic were more likely to have received a DDKT, but had similar calculated panel–reactive antibody (cPRA) values, waitlist time, and cause of kidney failure as before the pandemic. Conclusions: The COVID-19 pandemic initially reduced access to kidney transplantation among pediatric patients in the USA but has not had a sustained effect.
AB - Background: In March 2020, COVID-19 infections began to rise exponentially in the USA, placing substantial burden on the healthcare system. As a result, there was a rapid change in transplant practices and policies, with cessation of most procedures. Our goal was to understand changes to pediatric kidney transplantation (KT) at the national level during the COVID-19 epidemic. Methods: Using SRTR data, we examined changes in pediatric waitlist registration, waitlist removal or inactivation, and deceased donor and living donor (DDKT/LDKT) events during the start of the disease transmission in the USA compared with the same time the previous year. Results: We saw an initial decrease in DDKT and LDKT by 47% and 82% compared with expected events and then a continual increase, with numbers reaching expected prepandemic levels by May 2020. In the early phase of the pandemic, waitlist inactivation and removals due to death or deteriorating condition rose above expected values by 152% and 189%, respectively. There was a statistically significant decrease in new waitlist additions (IRR 0.49 0.65 0.85) and LDKT (IRR 0.17 0.38 0.84) in states with high vs. low COVID activity. Transplant recipients during the pandemic were more likely to have received a DDKT, but had similar calculated panel–reactive antibody (cPRA) values, waitlist time, and cause of kidney failure as before the pandemic. Conclusions: The COVID-19 pandemic initially reduced access to kidney transplantation among pediatric patients in the USA but has not had a sustained effect.
KW - Donation
KW - Infectious agents-viral
KW - Kidney transplantation
KW - Pediatrics
KW - Registry analysis
UR - http://www.scopus.com/inward/record.url?scp=85091614427&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85091614427&partnerID=8YFLogxK
U2 - 10.1007/s00467-020-04764-4
DO - 10.1007/s00467-020-04764-4
M3 - Article
C2 - 32980942
AN - SCOPUS:85091614427
SN - 0931-041X
VL - 36
SP - 143
EP - 151
JO - Pediatric Nephrology
JF - Pediatric Nephrology
IS - 1
ER -