■:自2020年3月11日宣布为全球大流行以来,COVID-19对实体器官移植产生了重大影响。这项研究的目的是分析COVID-19对美国肝移植(LT)的影响。
■:我们回顾性分析了器官共享联合网络数据库中有关捐献者特征的信息,成人-LT接受者,和COVID早期(2020年3月11日至9月11日)的移植结果,并将其与COVID前期(2019年3月11日至9月11日)进行比较。
■:总的来说,在COVID早期进行的LTs减少4%(4107对4277)。与前COVID时期相比,在COVID早期进行的移植与:酒精性肝病增加是最常见的主要诊断(1315vs1187,P<0.01),受者MELD评分较高(25vs23,P<0.01),等待名单上的时间较低(52天vs84天,P<0.01),移植时对血液透析的需求更高(9.4vs11.1%,P=0.012),与受援医院的距离更长(131对64英里,P<0.01)和更高的供体风险指数(1.65vs1.55,P<0.01)。COVID早期在出院前出现排斥反应(4.6%vs3.4%,P=0.023)和较低的90天移植物/患者存活率(90.2vs95.1%,P<0.01;92.2vs96.5%,P<0.01)。在多变量cox回归分析中,早期COVID期是移植后90天移植失败的独立危险因素(危险比1.77,P<0.01).
■:在美国的早期COVID时期,整体LT下降,酒精性肝病是LT的主要诊断,出院前的排斥反应发生率较高,移植后90天移植物存活率较低.
UNASSIGNED: : Since its declaration as a global pandemic on March11th 2020, COVID-19 has had a significant effect on solid-organ transplantation. The aim of this study was to analyze the impact of COVID-19 on Liver transplantation (LT) in United States.
UNASSIGNED: : We retrospectively analyzed the United Network for Organ Sharing database regarding characteristics of donors, adult-LT recipients, and transplant outcomes during early-COVID period (March 11- September 11, 2020) and compared them to pre-COVID period (March 11 - September 11, 2019).
UNASSIGNED: : Overall, 4% fewer LTs were performed during early-COVID period (4107 vs 4277). Compared to pre-COVID period, transplants performed in early-COVID period were associated with: increase in alcoholic liver disease as most common primary diagnosis (1315 vs 1187, P< 0.01), higher MELD score in the recipients (25 vs 23, P<0.01), lower time on wait-list (52 vs 84 days, P<0.01), higher need for hemodialysis at transplant (9.4 vs 11.1%, P=0.012), longer distance from recipient hospital (131 vs 64 miles, P<0.01) and higher donor risk index (1.65 vs 1.55, P<0.01). Early-COVID period saw increase in rejection episodes before discharge (4.6 vs 3.4%, P=0.023) and lower 90-day graft/patient survival (90.2 vs 95.1 %, P<0.01; 92.2 vs 96.5 %, P<0.01). In multivariable cox-regression analysis, early-COVID period was the independent risk factor for graft failure at 90-days post-transplant (Hazard Ratio 1.77, P<0.01).
UNASSIGNED: : During early-COVID period in United States, overall LT decreased, alcoholic liver disease was primary diagnosis for LT, rate of rejection episodes before discharge was higher and 90-days post-transplant graft survival was lower.