Emergency actions help members protect patient safety and access to transplant during COVID-19

Emergency actions help members protect patient safety and access to transplant during COVID-19

At its June 7 meeting, by teleconference, the Organ Procurement and Transplantation Network Executive Committee was briefed on data showing effects, to date, of several operational actions members approved in March and April 2020 in response to the COVID-19 pandemic. The actions, summarized on the COVID-19 resource page, were collectively intended to help members document the effects of COVID-19 on organ donation and transplantation, and to help members focus resources on essential clinical services in the short term.

The presentation slides are available here.

Key findings include the following:

  • On a temporary basis, transplant programs may report the most recent clinical data values available for waitlisted transplant candidates if they cannot collect updated data due to issues related to COVID-19. The number and percent of candidates for whom this provision has been used are very small.
  • Kidney programs that intend to register a transplant candidate who has not begun dialysis but who may otherwise qualify for transplant waiting time may modify the candidate’s wait time initiation date at a later time. New adult kidney waitlist registration counts have decreased during COVID-19, but the percent of additions qualifying for waiting time by other medical criteria has remained fairly stable.
  • The required submission of living donor follow-up, transplant recipient follow-up, and recipient malignancy forms has been suspended for forms expected on or after March 13. These forms are placed into an “amnesty” status. The number and percent of forms in this status has grown since policy implementation, but graft failures and patient deaths are still being reported on a timely basis.
  • Non-kidney transplant candidates do not accrue waiting time for a transplant if they are placed in an inactive status. For this reason, the OPTN recommended that non-kidney transplant programs that opt to defer any offers for certain candidates due to COVID-19 should not inactivate the candidate, but instead change their organ acceptance criteria. Many registrations moved from inactive to active status with the recommended change in acceptance criteria, which means the community read the guidance and reacted accordingly.
  • Most organ types reached a peak of 40-to-60 percent of matches with at least one COVID-19 related offer refusal entered. Since those peaks, the usage of COVID-19 related refusal reasons is decreasing.
  • Kidney candidates and recipients accounted for the highest proportion of reported patient deaths related to COVID-19.
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