Impact of COVID‐19 pandemic on the size of US transplant waiting lists

Abstract

Background More patients are waitlisted for solid organs than transplants are performed each year. The COVID‐19 pandemic immediately increased waitlist mortality and decreased transplants and listings. Methods To calculate the number of candidate listings after the pandemic began and short‐term changes that may affect waiting time, we conducted a Scientific Registry of Transplant Recipients surveillance study from January 1, 2012 to February 28, 2021. Results The number of candidates on the liver waitlist continued a steady decline that began before the pandemic. Numbers of candidates on the kidney, heart, and lung waitlists decreased dramatically. More than 3000 fewer candidates were awaiting a kidney transplant on March 7, 2021, than on March 8, 2020. Listings and removals decreased for each solid organ beginning in March 2020. The number of heart and lung listings returned to equal or above that of removals. Listings for kidney transplant, which is often less urgent than heart and lung transplant, remain below numbers of removals. Removals due to transplant decreased for all organs, while removals due to death increased for only kidneys. Conclusions We found no evidence of the predicted surge in listings for solid organ transplant with a plateau or control of the pandemic.

Implementation of a National Liver Review Board for exception requests in the United States: A 2-year monitoring report

“…Due to reduced transplant center activity initially in certain areas of the country, there may have been fewer exception cases being listed; in addition, deaths due to COVID-19 before or after transplant could have influenced waitlist and transplant outcome metrics for the postpolicy era. [7][8][9] Beginning on June 28, 2022, the median transplant score for exception cases is based on transplants performed within 150 nm from the donor hospital, rather than 250 nm around the transplant hospital. This would not have affected the current analysis, but the effects of this change remain to be seen, and outcomes after this policy will continue to be monitored.…”

“…COVID-19 was declared a national emergency in the United States on March 13, 2020, meaning that most of the postpolicy era occurred in the context of COVID-19. Due to reduced transplant center activity initially in certain areas of the country, there may have been fewer exception cases being listed; in addition, deaths due to COVID-19 before or after transplant could have influenced waitlist and transplant outcome metrics for the postpolicy era 7–9 …”

Evolving Trends in Kidney Transplant Outcomes Among Older Adults: A Comparative Analysis Before and During the COVID-19 Pandemic

“…24 Moreover, studies have also reported increased waitlist removals due to mortality during the initial phases of the COVID-19 pandemic, which may also reflect higher mortality rates among older adults awaiting KT. 65…”

Abdominal Organ Transplantation: Noteworthy Literature in 2022

“…Miller et al utilized Scientific Registry of Transplant Recipients (SRTR) data to examine waitlist trends from 2012 to 2021. 1 The heart and liver transplant waitlists had been declining prior to 2020, while the kidney and lung waitlists remained roughly unchanged from 2018 to 2020. All waitlists shrunk in the first half of 2020 because of COVID-19.…”