TY - JOUR
T1 - Survey of US Living Kidney Donation and Transplantation Practices in the COVID-19 Era
AU - Lentine, Krista L.
AU - Vest, Luke S.
AU - Schnitzler, Mark A.
AU - Mannon, Roslyn B.
AU - Kumar, Vineeta
AU - Doshi, Mona D.
AU - Cooper, Matthew
AU - Mandelbrot, Didier A.
AU - Harhay, Meera N.
AU - Josephson, Michelle A.
AU - Caliskan, Yasar
AU - Sharfuddin, Asif
AU - Kasiske, Bertram L.
AU - Axelrod, David A.
N1 - Funding Information:
KLL is supported by the Mid-America Transplant/Jane A. Beckman Endowed Chair in Transplantation. MNH is supported by National Institutes of Health grants K23DK105207 and R01DK124388. The authors thank the survey respondents, including members of the American Society of Transplantation (AST) Kidney Pancreas Community of Practice (COP), Live Donor COP, and AST Outstanding Questions in Transplantation list servs, and the AST Education Committee for review of the survey instrument. An abstract describing preliminary findings was accepted to the American Society of Nephrology Kidney Week (virtual program, October 2020). Data availability is limited to aggregate summaries as reported, based on IRB requirements.
Funding Information:
KLL is supported by the Mid-America Transplant/Jane A. Beckman Endowed Chair in Transplantation. MNH is supported by National Institutes of Health grants K23DK105207 and R01DK124388 . The authors thank the survey respondents, including members of the American Society of Transplantation (AST) Kidney Pancreas Community of Practice (COP), Live Donor COP, and AST Outstanding Questions in Transplantation list servs, and the AST Education Committee for review of the survey instrument. An abstract describing preliminary findings was accepted to the American Society of Nephrology Kidney Week (virtual program, October 2020).
Publisher Copyright:
© 2020 International Society of Nephrology
PY - 2020/11
Y1 - 2020/11
N2 - Introduction: The scope of the impact of the coronavirus disease 2019 (COVID-19) pandemic on living donor kidney transplantation (LDKT) practices is not well defined. Methods: We surveyed US transplant programs to assess practices, strategies, and barriers to living LDKT during the COVID-19 pandemic. After institutional review board approval, the survey was distributed from 9 May 2020 to 30 May 2020 by e-mail and postings to professional society list-servs. Responses were stratified based on state COVID-19 cumulative incidence levels. Results: Staff at 118 unique centers responded, representing 61% of US living donor recovery programs and 75% of LKDT volume in the prepandemic year. Overall, 66% reported that LDKT surgery was on hold (81% in “high” vs. 49% in “low” COVID-19 cumulative incidence states). A total of 36% reported that evaluation of new donor candidates had paused, 27% reported that evaluations were very much decreased (>0% to <25% typical), and 23% reported that evaluations were moderately decreased (25% to <50% typical). Barriers to LDKT surgery included program concerns for donor (85%) and recipient (75%) safety, patient concerns (56%), elective case restrictions (47%), and hospital administrative restrictions (48%). Programs with higher local COVID-19 cumulative incidence reported more barriers related to staff and resource diversion. Most centers continuing donor evaluations used remote strategies (video, 82%; telephone, 43%). As LDKT resumes, all programs will screen for COVID-19, although timeframe and modalities will vary. Recommendations for presurgical self-quarantine are also variable. Conclusion: The COVID-19 pandemic has had broad impacts on LDKT practice. Ongoing research and consensus building are needed to reduce barriers, to guide optimal practices, and to support safe restoration of LDKT across centers.
AB - Introduction: The scope of the impact of the coronavirus disease 2019 (COVID-19) pandemic on living donor kidney transplantation (LDKT) practices is not well defined. Methods: We surveyed US transplant programs to assess practices, strategies, and barriers to living LDKT during the COVID-19 pandemic. After institutional review board approval, the survey was distributed from 9 May 2020 to 30 May 2020 by e-mail and postings to professional society list-servs. Responses were stratified based on state COVID-19 cumulative incidence levels. Results: Staff at 118 unique centers responded, representing 61% of US living donor recovery programs and 75% of LKDT volume in the prepandemic year. Overall, 66% reported that LDKT surgery was on hold (81% in “high” vs. 49% in “low” COVID-19 cumulative incidence states). A total of 36% reported that evaluation of new donor candidates had paused, 27% reported that evaluations were very much decreased (>0% to <25% typical), and 23% reported that evaluations were moderately decreased (25% to <50% typical). Barriers to LDKT surgery included program concerns for donor (85%) and recipient (75%) safety, patient concerns (56%), elective case restrictions (47%), and hospital administrative restrictions (48%). Programs with higher local COVID-19 cumulative incidence reported more barriers related to staff and resource diversion. Most centers continuing donor evaluations used remote strategies (video, 82%; telephone, 43%). As LDKT resumes, all programs will screen for COVID-19, although timeframe and modalities will vary. Recommendations for presurgical self-quarantine are also variable. Conclusion: The COVID-19 pandemic has had broad impacts on LDKT practice. Ongoing research and consensus building are needed to reduce barriers, to guide optimal practices, and to support safe restoration of LDKT across centers.
KW - COVID-19
KW - kidney transplantation
KW - living kidney donation
KW - pandemic
KW - screening
KW - telehealth
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U2 - 10.1016/j.ekir.2020.08.017
DO - 10.1016/j.ekir.2020.08.017
M3 - Article
AN - SCOPUS:85092087514
VL - 5
SP - 1894
EP - 1905
JO - Kidney International Reports
JF - Kidney International Reports
SN - 2468-0249
IS - 11
ER -