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Prioritizing Heart Transplantation During the COVID-19 Pandemic
  • +12
  • Keki Balsara,
  • Zakiur Rahaman,
  • Emily Sandhaus,
  • Jordan Hoffman,
  • Sandip Zalawadiya,
  • William McMaster,
  • JoAnn Lindenfeld,
  • Mark Wigger,
  • Tarek Absi,
  • Douglas Brinkley,
  • Jonathan Menachem,
  • Lynn Punnoose,
  • Suzie Sacks,
  • Kelly Schlendorf,
  • Ashish Shah
Keki Balsara
Vanderbilt University Medical Center
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Zakiur Rahaman
Vanderbilt University Medical Center
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Emily Sandhaus
Vanderbilt University Medical Center
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Jordan Hoffman
Vanderbilt University Medical Center
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Sandip Zalawadiya
Vanderbilt University Medical Center
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William McMaster
Vanderbilt University Medical Center
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JoAnn Lindenfeld
Vanderbilt University Medical Center
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Mark Wigger
Vanderbilt University Medical Center
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Tarek Absi
Vanderbilt University Medical Center
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Douglas Brinkley
Vanderbilt University Medical Center
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Jonathan Menachem
Vanderbilt University Medical Center
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Lynn Punnoose
Vanderbilt University Medical Center
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Suzie Sacks
Vanderbilt University Medical Center
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Kelly Schlendorf
Vanderbilt University Medical Center
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Ashish Shah
Vanderbilt University Medical Center
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Abstract

BACKGROUND: COVID-19 has significantly impacted the healthcare landscape in the United States in a variety of ways including a nation-wide reduction in operative volume. The impact of COVID-19 on the availability of donor organs and the impact on solid organ transplant remains unclear. We examine the impact of COVID-19 on a single, large-volume heart transplant program. METHODS: A retrospective chart review was performed examining all adult heart transplants performed at a single institution between March 2020 and June 2020. This was compared to the same time frame in 2019. We examined incidence of primary graft dysfunction (PGD), continuous renal replacement therapy (CRRT) and 30-day survival. RESULTS: From March-June 2020, 43 orthotopic heart transplants were performed compared to 31 performed during 2019. Donor and recipient demographics demonstrated no differences. There was no difference in 30-day survival. There was a statistically significant difference in incidence of post-operative CRRT (9/31 v. 3/43; p = .01). There was a statistically significant difference in race (23W/8B/1AA v. 30W/13B; P=.029). CONCLUSION: We demonstrate that a single, large-volume transplant program was able to grow volume with little difference in donor variables and clinical outcomes following transplant. While multiple reasons are possible, most likely the reduction of volume at other programs allowed us to utilize organs to which we would not have previously had access. More significantly, our growth in volume was coupled with no instances of COVID-19 infection or transmission amongst patients or staff due to an aggressive testing and surveillance program.

Peer review status:ACCEPTED

22 Jan 2021Submitted to Journal of Cardiac Surgery
22 Jan 2021Submission Checks Completed
22 Jan 2021Assigned to Editor
29 Jan 2021Reviewer(s) Assigned
12 Feb 2021Review(s) Completed, Editorial Evaluation Pending
15 Feb 2021Editorial Decision: Revise Major
21 Feb 20211st Revision Received
23 Feb 2021Assigned to Editor
23 Feb 2021Submission Checks Completed
23 Feb 2021Reviewer(s) Assigned
27 Feb 2021Review(s) Completed, Editorial Evaluation Pending
28 Feb 2021Editorial Decision: Revise Minor
14 Mar 20212nd Revision Received
22 Mar 2021Submission Checks Completed
22 Mar 2021Assigned to Editor
20 Apr 2021Reviewer(s) Assigned
27 Apr 2021Review(s) Completed, Editorial Evaluation Pending
17 May 2021Editorial Decision: Accept