COVID-19 pandemic: Building organisational flexibility to scale transplant programs

Abstract

The prevailing coronavirus disease 2019 pandemic has challenged our lives in an unprecedented manner. The pandemic has had a significant impact on transplantation worldwide. The logistics of travel restrictions, stretching of available resources, unclear risk of infection in immunosuppressed transplant recipients, and evolving guidelines on testing and transplantation are some of the factors that have unfavourably influenced transplant activity. We must begin to build organisational flexibility in order to restart transplantation so that we can be mindful stewards of organ donation and sincere advocates for our patients. Building a culture of honesty and transparency (with patients, families, colleagues, societies, and authorities), keeping the channels of communication open, working in collaboration with others (at local, regional, national, and international levels), and not restarting without rethinking and appraising all elements of our practice, are the main underlying principles to increase the flexibility.

The solid organ transplant recipient with SARS-CoV-2 infection

“…A study comparing COVID-19 patients waitlisted for kidney transplant with those post kidney transplant found that waitlist status was independently associated with mortality [25]. Efforts to build organizational flexibility at transplant centres and to encourage dialogue between providers have helped the transplant community to continue to provide its live-saving services to patients [26,27].…”