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Prioritizing heart transplantation during the COVID‐19 pandemic
Author(s) -
Balsara Keki R.,
Rahaman Zakiur,
Sandhaus Emily,
Hoffman Jordan,
Zalawadiya Sandip,
McMaster William,
Lindenfeld Joann,
Wigger Mark,
Absi Tarek,
Brinkley Douglas M.,
Menachem Jonathan,
Punnoose Lynn,
Sacks Suzie,
Schlendorf Kelly,
Shah Ashish S.
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15731
Subject(s) - medicine , incidence (geometry) , heart transplantation , covid-19 , transplantation , pandemic , intravascular volume status , retrospective cohort study , demographics , heart transplants , renal replacement therapy , emergency medicine , intensive care medicine , disease , demography , hemodynamics , infectious disease (medical specialty) , physics , sociology , optics
Background Coronavirus disease 2019 (COVID‐19) has significantly impacted the healthcare landscape in the United States in a variety of ways including a nation‐wide reduction in operative volume. The impact of COVID‐19 on the availability of donor organs and the impact on solid organ transplant remains unclear. We examine the impact of COVID‐19 on a single, large‐volume heart transplant program. Methods A retrospective chart review was performed examining all adult heart transplants performed at a single institution between March 2020 and June 2020. This was compared to the same time frame in 2019. We examined incidence of primary graft dysfunction, continuous renal replacement therapy (CRRT) and 30‐day survival. Results From March to June 2020, 43 orthotopic heart transplants were performed compared to 31 performed during 2019. Donor and recipient demographics demonstrated no differences. There was no difference in 30‐day survival. There was a statistically significant difference in incidence of postoperative CRRT (9/31 vs. 3/43; p = .01). There was a statistically significant difference in race (23 W/8B/1AA vs. 30 W/13B; p = .029). Conclusion We demonstrate that a single, large‐volume transplant program was able to grow volume with little difference in donor variables and clinical outcomes following transplant. While multiple reasons are possible, most likely the reduction of volume at other programs allowed us to utilize organs to which we would not have previously had access. More significantly, our growth in volume was coupled with no instances of COVID‐19 infection or transmission amongst patients or staff due to an aggressive testing and surveillance program.