Transplantation DirectPub Date : 2024-08-08eCollection Date: 2024-09-01DOI: 10.1097/TXD.0000000000001690
Leela Morená, Ayman Al Jurdi, Christopher El Mouhayyar, Rucháma Verhoeff, Nora Alzahrani, Camille N Kotton, Leonardo V Riella
{"title":"Post-acute Sequelae of COVID-19 Among Solid Organ Transplant Recipients: Insights From the Omicron Period.","authors":"Leela Morená, Ayman Al Jurdi, Christopher El Mouhayyar, Rucháma Verhoeff, Nora Alzahrani, Camille N Kotton, Leonardo V Riella","doi":"10.1097/TXD.0000000000001690","DOIUrl":"10.1097/TXD.0000000000001690","url":null,"abstract":"<p><strong>Background: </strong>In solid organ transplant recipients (SOTRs), studies investigating post-acute sequelae of SARS-CoV-2 infection (PASC) are limited, and risk factors for their development require further investigation.</p><p><strong>Methods: </strong>In this cross-sectional study, we evaluated PASC symptoms among SOTRs followed at our institutions who had COVID-19 during the Omicron period from December 28, 2021, to November 4, 2022. Participants were surveyed using a newly published PASC score containing 13 symptoms experienced for ≥30 d. PASC was defined as a score of ≥12.</p><p><strong>Results: </strong>Of 299 SOTRs invited, 93 completed the survey and were analyzed. The mean age was 58 y and 43% were women. Forty-six individuals (49%) reported experiencing ≥1 PASC symptom for ≥30 d, of whom 13 (14%) met the PASC definition. Multivariable analysis showed that female sex (adjusted odds ratio [aOR] = 0.32; 95% confidence interval [CI], 0.12-0.83), years from transplantation (aOR = 0.90 per additional year; 95% CI, 0.81-0.99), and tixagevimab-cilgavimab preexposure prophylaxis (aOR = 0.33; 95% CI, 0.12-0.84) were associated with significantly lower odds of developing ≥1 PASC symptom.</p><p><strong>Conclusions: </strong>PASC symptoms are common in SOTRs infected during the Omicron period. PASC symptoms are less frequent in those with a longer time since transplant and in those who received tixagevimab-cilgavimab. New SARS-CoV-2 prevention and treatment strategies should also evaluate PASC symptoms as outcomes.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"10 9","pages":"e1690"},"PeriodicalIF":1.9,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transplantation DirectPub Date : 2024-08-08eCollection Date: 2024-09-01DOI: 10.1097/TXD.0000000000001680
Malte Ziemann, Monika Lindemann, Michael Hallensleben, Wolfgang Altermann, Karina Althaus, Klemens Budde, Gunilla Einecke, Ute Eisenberger, Andrea Ender, Thorsten Feldkamp, Florian Grahammer, Martina Guthoff, Christopher Holzmann-Littig, Christian Hugo, Teresa Kauke, Stephan Kemmner, Martina Koch, Nils Lachmann, Matthias Marget, Christian Morath, Martin Nitschke, Lutz Renders, Sabine Scherer, Julian Stumpf, Vedat Schwenger, Florian Sommer, Bernd Spriewald, Caner Süsal, Daniel Zecher, Falko M Heinemann, Murielle Verboom
{"title":"Risk Stratification Before Living Donor Kidney Transplantation in Patients With Preformed Donor-specific Antibodies by Different Crossmatch Methods.","authors":"Malte Ziemann, Monika Lindemann, Michael Hallensleben, Wolfgang Altermann, Karina Althaus, Klemens Budde, Gunilla Einecke, Ute Eisenberger, Andrea Ender, Thorsten Feldkamp, Florian Grahammer, Martina Guthoff, Christopher Holzmann-Littig, Christian Hugo, Teresa Kauke, Stephan Kemmner, Martina Koch, Nils Lachmann, Matthias Marget, Christian Morath, Martin Nitschke, Lutz Renders, Sabine Scherer, Julian Stumpf, Vedat Schwenger, Florian Sommer, Bernd Spriewald, Caner Süsal, Daniel Zecher, Falko M Heinemann, Murielle Verboom","doi":"10.1097/TXD.0000000000001680","DOIUrl":"10.1097/TXD.0000000000001680","url":null,"abstract":"<p><strong>Background: </strong>Preformed donor-specific HLA antibodies (DSA) are a well-known risk factor in kidney transplantation. There is still considerable debate, however, about the optimal risk stratification among patients with preformed DSA. Additionally, data on the prognostic value of different crossmatch assays in DSA-positive patients are scarce.</p><p><strong>Methods: </strong>DSA-positive living kidney transplant recipients were selected from a multicenter study examining 4233 consecutive renal transplants. An additional 7 patients from 2 further centers were included. Flow cytometric crossmatches (FXM), Luminex-based crossmatches, and virtual crossmatches based on C1q- and C3d-binding antibodies (C1qXM and C3dXM) were performed retrospectively using pretransplant sera and lymphocytes isolated from fresh samples. These samples were obtained from 44 donor and recipient pairs from 12 centers. Clinical outcome data and the control group without DSA were compiled from the previous study and were supplemented by data on 10-y death-censored graft survival (10yGS).</p><p><strong>Results: </strong>Between 19% (C3dXM) and 46% (FXM) of crossmatches were positive. Crossmatch-positive patients showed high incidences of antibody-mediated rejection (AMR) within 6 mo (up to 60% in B-cell FXM+ patients). The incidence of AMR in crossmatch-negative patients ranged between 5% (FXM-) and 13% (C1qXM-). 10yGS was significantly impaired in patients with positive T-cell FXM and total FXM compared with both patients without DSA and those with DSA with negative FXM.</p><p><strong>Conclusions: </strong>Especially FXM are useful for risk stratification, as the outcome of DSA-positive, FXM-negative patients is similar to that of DSA-negative patients, whereas FXM-positive patients have both more AMR and decreased 10yGS. Because of their lower sensitivity, the significance of Luminex-based crossmatches, C1qXM, and C3dXM would have to be examined in patients with stronger DSA.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"10 9","pages":"e1680"},"PeriodicalIF":1.9,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transplantation DirectPub Date : 2024-08-08eCollection Date: 2024-09-01DOI: 10.1097/TXD.0000000000001693
Miah T Li, Grace C Hillyer, Kristen L King, Miko Yu, S Ali Husain, Sumit Mohan
{"title":"Knowledge, Attitudes, and Beliefs Toward Organ Donation Registration Among Asian Americans: Development and Pilot-testing of Educational Intervention Video.","authors":"Miah T Li, Grace C Hillyer, Kristen L King, Miko Yu, S Ali Husain, Sumit Mohan","doi":"10.1097/TXD.0000000000001693","DOIUrl":"10.1097/TXD.0000000000001693","url":null,"abstract":"<p><strong>Background: </strong>Organ donation registration rates in the United States are lowest among Asian Americans. This study aimed to investigate the reasons for low organ donation registration rates among Asian Americans and develop educational material to help improve organ donation rates and awareness.</p><p><strong>Methods: </strong>We conducted a 2-phase study. In phase 1, a cross-sectional observational survey was distributed in-person on an iPad to members of the Asian community in Queens, New York, to investigate their knowledge, attitudes, and beliefs toward organ donation. Based on the results, an educational video was developed, and the efficacy of the video was assessed with an independent cohort of participants in phase 2 using a pre-/post-video comprehension assessment survey.</p><p><strong>Results: </strong>Among 514 Chinese or Korean Americans who participated in the phase 1 survey, 97 participants (19%) reported being registered organ donors. Registered donors were more likely to have previously discussed their organ donation wishes with their family (adjusted odds ratio [aOR], 4.77; 95% confidence interval [CI], 2.56-8.85; <i>P</i> < 0.01), knowledge of the different registration methods (aOR, 2.57; 95% CI, 1.24-5.31; <i>P</i> < 0.01), or know a registered organ donor (aOR, 2.62; 95% CI, 1.39-4.95; <i>P</i> < 0.01). For the educational video efficacy assessment given pre-/post-video, the majority (90%) of the respondents reported learning something new from the video. After watching the video, there was a significant improvement in the mean knowledge score regarding organ donation (63% versus 92%; <i>P</i> < 0.01) and an increase in intention to have discussion regarding organ donation with family.</p><p><strong>Conclusions: </strong>We found varies factors associated with low organ donation registration rates among Asian Americans and demonstrated the potential of our educational video to impart organ donation knowledge to viewers and instigate the intention to have family discussions regarding organ donation. Further research is needed to assess the impact of videos in motivating actual organ donation registration.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"10 9","pages":"e1693"},"PeriodicalIF":1.9,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transplantation DirectPub Date : 2024-07-29eCollection Date: 2024-08-01DOI: 10.1097/TXD.0000000000001684
Mario Romero-Cristóbal, Fernando Díaz-Fontenla, Ainhoa Fernández-Yunquera, Aranzazu Caballero-Marcos, Andrés Conthe, Enrique Velasco, José Pérez-Peña, José-Ángel López-Baena, Diego Rincón, Rafael Bañares, Magdalena Salcedo
{"title":"Demographic Trends in Liver Transplant Survivors After 3 Decades of Program Implementation: The Impact of Cohort and Period Effects on Life Expectancy.","authors":"Mario Romero-Cristóbal, Fernando Díaz-Fontenla, Ainhoa Fernández-Yunquera, Aranzazu Caballero-Marcos, Andrés Conthe, Enrique Velasco, José Pérez-Peña, José-Ángel López-Baena, Diego Rincón, Rafael Bañares, Magdalena Salcedo","doi":"10.1097/TXD.0000000000001684","DOIUrl":"10.1097/TXD.0000000000001684","url":null,"abstract":"<p><strong>Background: </strong>Demographic analyses may reveal current patterns of change in the outcomes of rapidly developing medical procedures because they incorporate the period perspective.</p><p><strong>Methods: </strong>We analyzed the changes in size, age structure, and hospitalizations in the population of liver transplantation (LT) survivors in our center during the last 30 y (n = 1114 patients) and generated projections, including life expectancy (LE), considering cohort and period effects. Life tables were used to project the complete LE (overall 1990-2020 experience), the cohort LE (according to the decade of surgery: 1990-2000, 2000-2010, and 2010-2020), and the period LE (current 2015-2020 experience).</p><p><strong>Results: </strong>The population of LT recipients in follow-up continued to experience progressive growth and aging since 1990 (492 patients [41.9% >65 y] in 2020), and the magnitude of these phenomena may double in the next 30 y. However, the number of admissions and days of admission has been decreasing. The complete LE at LT was 12.4 y, whereas the period LE was 15.8 y. The cohort LE (limited to 10 y) was 5.3, 6.3, and 7.3 y for the 1990-2000, 2000-2010, and 2010-2020 cohorts, respectively.</p><p><strong>Conclusions: </strong>The target population of our medical care after LT is growing and aging. The prevalence of both of these phenomena is expected to increase in the coming years and is associated with a current improvement in LE. However, the hospitalization burden associated with LT survivors is declining. The period effect should be considered for generating up-to-date information on these current trends, which are crucial when designing health policies for LT survivors.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"10 8","pages":"e1684"},"PeriodicalIF":1.9,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transplantation DirectPub Date : 2024-07-26eCollection Date: 2024-08-01DOI: 10.1097/TXD.0000000000001682
Brian I Shaw, Michela M Fabricius, Christopher L Nauser, Sabino Zani, Stuart J Knechtle
{"title":"Video-assisted Retroperitoneal Debridement for Graft Pancreatitis.","authors":"Brian I Shaw, Michela M Fabricius, Christopher L Nauser, Sabino Zani, Stuart J Knechtle","doi":"10.1097/TXD.0000000000001682","DOIUrl":"10.1097/TXD.0000000000001682","url":null,"abstract":"","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"10 8","pages":"e1682"},"PeriodicalIF":1.9,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11286245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transplantation DirectPub Date : 2024-07-26eCollection Date: 2024-08-01DOI: 10.1097/TXD.0000000000001681
Ahmed Zidan, Hammam Momani, Bodhisatwa Sengupta, Rehab Abdullah, Razan Bader, Iftikhar Khan, Mansour Tawfeeq, Mohammed Al Qahtani
{"title":"Expanding the Donor Pool to the Ultimate Level: Introducing the Revolutionary Hybrid Dual Graft Liver Transplant Using Domino and Living Donors.","authors":"Ahmed Zidan, Hammam Momani, Bodhisatwa Sengupta, Rehab Abdullah, Razan Bader, Iftikhar Khan, Mansour Tawfeeq, Mohammed Al Qahtani","doi":"10.1097/TXD.0000000000001681","DOIUrl":"10.1097/TXD.0000000000001681","url":null,"abstract":"<p><strong>Background: </strong>Innovative solutions are crucial as the demand for liver transplants continues to outpace available grafts. Dual graft liver transplantation offers a promising avenue to address graft volume challenges while minimizing donor risks. This report introduces a groundbreaking approach, combining a full organ domino donor graft with a living donor graft for a hybrid dual graft liver transplant.</p><p><strong>Brief report: </strong>A 2-y-old child with Maple syrup urine disease and a 40-y-old adult with end-stage liver disease became the focus of this unique case. A hybrid dual graft liver transplant was executed, uniting the domino donor's full organ graft with a living donor's left lateral segment. Precise vascular and biliary reconstructions facilitated a successful transplant.</p><p><strong>Conclusions: </strong>The hybrid dual graft liver transplant, merging domino donor and living donor grafts, presents a viable strategy to combat graft shortages, particularly in regions predominantly reliant on living donor transplants. Despite challenges, this pioneering approach should be embraced by established liver transplant centers because it enables concurrent living donor liver transplantation while prioritizing donor safety and recipient outcomes.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"10 8","pages":"e1681"},"PeriodicalIF":1.9,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11286240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transplantation DirectPub Date : 2024-07-26eCollection Date: 2024-08-01DOI: 10.1097/TXD.0000000000001688
Sachiko M Oshima, Wei Chen, Aparna Rege, Andrew S Barbas, Stephanie Garbarino
{"title":"Rapid Development of Post-Liver Transplantation Nodular Regenerative Hyperplasia and Portal Hypertension After Perfusion Pump Use: A Case Series.","authors":"Sachiko M Oshima, Wei Chen, Aparna Rege, Andrew S Barbas, Stephanie Garbarino","doi":"10.1097/TXD.0000000000001688","DOIUrl":"10.1097/TXD.0000000000001688","url":null,"abstract":"","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"10 8","pages":"e1688"},"PeriodicalIF":1.9,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11286241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Cost-effectiveness of Valganciclovir Prophylaxis Versus Preemptive Therapy in CMV R+ Kidney Transplant Recipients Over the First Year Posttransplantation.","authors":"Claire Villeneuve, Jean-Phillipe Rerolle, Lionel Couzi, Pierre-Francois Westeel, Isabelle Etienne, Laure Esposito, Nassim Kamar, Mathias Büchler, Antoine Thierry, Pierre Marquet, Caroline Monchaud","doi":"10.1097/TXD.0000000000001678","DOIUrl":"10.1097/TXD.0000000000001678","url":null,"abstract":"<p><strong>Background: </strong>In kidney transplant recipients with positive serology (R+) for the cytomegalovirus (CMV), 2 strategies are used to prevent infection, whose respective advantages over the other are still debated. This study aimed to evaluate the cost-effectiveness and cost utility of antiviral prophylaxis against CMV versus preemptive therapy, considering CMV infection-free survival over the first year posttransplantation as the main clinical outcome.</p><p><strong>Methods: </strong>Clinical, laboratory, and economic data were collected from 186 kidney transplant patients CMV (R+) included in the cohort study (85 patients who benefited from CMV prophylaxis and 101 from preemptive therapy). Costs were calculated from the hospital perspective and quality-adjusted life years (QALYs) using the EQ5D form. Using nonparametric bootstrapping, the incremental cost-effectiveness ratio (ICER) and cost utility were estimated (euros) for each case of infection avoided and each QALY gained for 1 y, respectively.</p><p><strong>Results: </strong>Prophylaxis significantly decreased the risk of CMV infection over the first year posttransplantation (hazard ratio 0.22, 95% confidence interval = 0.12-0.37, <i>P</i> < 0.01). Compared with preemptive therapy, prophylaxis saved financial resources (€1155 per patient) and was more effective (0.42 infection avoided per patient), resulting in an ICER = €2769 per infection avoided. Prophylaxis resulted in a net gain of 0.046 in QALYs per patient and dominated over preemptive therapy with €1422 cost-saving for 1 QALY gained.</p><p><strong>Conclusions: </strong>This study shows that CMV prophylaxis, although considered as a more expensive strategy, is more cost-effective than preemptive therapy for the prevention of CMV infections in renal transplant patients. Prophylaxis had a positive effect on quality of life at reasonable costs and resulted in net savings for the hospital.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"10 8","pages":"e1678"},"PeriodicalIF":1.9,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11286253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transplantation DirectPub Date : 2024-07-18eCollection Date: 2024-08-01DOI: 10.1097/TXD.0000000000001686
Ann B Nguyen, Hannah F Roth, Bow Chung, Daniel Rodgers, Kevin J Clerkin, Gabriel Sayer, Gene Kim, Valluvan Jeevanandam, Mark Siegler, Nir Uriel, Andrew Aronsohn
{"title":"International Travel for Organ Transplantation: Provider and Patient Perspectives.","authors":"Ann B Nguyen, Hannah F Roth, Bow Chung, Daniel Rodgers, Kevin J Clerkin, Gabriel Sayer, Gene Kim, Valluvan Jeevanandam, Mark Siegler, Nir Uriel, Andrew Aronsohn","doi":"10.1097/TXD.0000000000001686","DOIUrl":"10.1097/TXD.0000000000001686","url":null,"abstract":"<p><strong>Background: </strong>Organ allocation in the United States to non-US citizen, non-US residents who travel for transplant (NC/NRTx) is controversial. Current policies may not be informed by stakeholder opinions, as limited data exist assessing the knowledge or opinions of providers or patients on this issue.</p><p><strong>Methods: </strong>A cross-sectional, hospital-based pilot survey was distributed to providers and patients from December 2019 to June 2020 at a single large urban transplant institute. Providers were members of the departments of surgery and medicine and included both transplant and nontransplant providers. Surveys included 10 questions on eligibility, prioritization, and limitations for deceased donor transplantation and 12 demographic questions.</p><p><strong>Results: </strong>A total of 209 providers responded (61% women, median age 40) and 119 patients responded (62% women, median age 54). Awareness of eligibility for transplantation of US citizens, non-US citizens residing in the United States (NC/R), and NC/NRTx was high in both groups, though providers and patients lacked awareness of the eligibility of nonlegal NC/R (those who live in the United States who are not citizens and are not legal residents) to donate and receive organs. Overall, 79.3% of patients stated that NC/NRTx should be eligible for transplant in the United States compared with only 60.7% of providers (<i>P</i> = 0.001). Providers were more likely than patients to prioritize transplant to legal NC/NR over NC/NRTx (58.2% versus 35.1%, <i>P</i> < 000.1) and reported that families should be able to limit donations to NC/NRTx (34.9% versus 23.2%, <i>P</i> = 0.03).</p><p><strong>Conclusions: </strong>Surveyed patients and providers generally support transplant in non-US citizens; however, the strength of support varied considerably based on the legal status of the patient and the occupation of those surveyed. Larger studies are necessary to develop data-informed policy.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"10 8","pages":"e1686"},"PeriodicalIF":1.9,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transplantation DirectPub Date : 2024-06-26eCollection Date: 2024-07-01DOI: 10.1097/TXD.0000000000001670
Kyla L Naylor, Gregory A Knoll, Darin Treleaven, Yuguang Kang, Amit X Garg, Kathryn Stirling, S Joseph Kim
{"title":"Comparison of COVID-19 Hospitalization and Death Between Solid Organ Transplant Recipients and the General Population in Canada, 2020-2022.","authors":"Kyla L Naylor, Gregory A Knoll, Darin Treleaven, Yuguang Kang, Amit X Garg, Kathryn Stirling, S Joseph Kim","doi":"10.1097/TXD.0000000000001670","DOIUrl":"10.1097/TXD.0000000000001670","url":null,"abstract":"<p><strong>Background: </strong>Solid organ transplant recipients have a high risk of severe outcomes from SARS-CoV-2 infection. A comprehensive understanding of the impact of the COVID-19 pandemic across multiple waves in the solid organ transplant population and how this compares to the general population is limited. We conducted a population-based cohort study using linked administrative healthcare databases from Ontario, Canada to answer this question.</p><p><strong>Methods: </strong>We included 15 306 solid organ transplant recipients and 12 160 904 individuals from the general population. Our primary outcome was the rate (per 100 person-years) of severe COVID-19 (ie, hospitalization or death with a positive SARS-CoV-2 test) occurring between January 25, 2020, and November 30, 2022.</p><p><strong>Results: </strong>Compared with the general population, solid organ transplant recipients had almost a 6 times higher rate of severe COVID-19 (20.39 versus 3.44 per 100 person-years), with almost 5.5 times as high a rate of death alone (4.19 versus 0.77 per 100 person-years). Transplant recipients with severe COVID-19 were substantially younger (60.1 versus 66.5 y) and had more comorbidities. The rate of severe COVID-19 declined over time in the solid organ transplant population, with an incidence rate of 41.25 per 100 person-years in the first wave (January 25, 2020, to August 31, 2020) and 18.41 in the seventh wave (June 19, 2022, to November 30, 2022, Omicron era).</p><p><strong>Conclusions: </strong>Solid organ transplant recipients remain at high risk of severe outcomes when they are infected with SARS-CoV-2. Resources and strategies to mitigate the impact of SARS-CoV-2 exposure are needed in this vulnerable patient population.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"10 7","pages":"e1670"},"PeriodicalIF":1.9,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}