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Immediate impact of COVID-19 on transplant activity in the Netherlands.

Abstract：

:The rapid emergence of the COVID-19 pandemic is unprecedented and poses an unparalleled obstacle in the sixty-five year history of organ transplantation. Worldwide, the delivery of transplant care is severely challenged by matters concerning - but not limited to - organ procurement, risk of SARS-CoV-2 transmission, screening strategies of donors and recipients, decisions to postpone or proceed with transplantation, the attributable risk of immunosuppression for COVID-19 and entrenched health care resources and capacity. The transplant community is faced with choosing a lesser of two evils: initiating immunosuppression and potentially accepting detrimental outcome when transplant recipients develop COVID-19 versus postponing transplantation and accepting associated waitlist mortality. Notably, prioritization of health care services for COVID-19 care raises concerns about allocation of resources to deliver care for transplant patients who might otherwise have excellent 1-year and 10-year survival rates. Children and young adults with end-stage organ disease in particular seem more disadvantaged by withholding transplantation because of capacity issues than from medical consequences of SARS-CoV-2. This report details the nationwide response of the Dutch transplant community to these issues and the immediate consequences for transplant activity. Worrisome, there was a significant decrease in organ donation numbers affecting all organ transplant services. In addition, there was a detrimental effect on transplantation numbers in children with end-organ failure. Ongoing efforts focus on mitigation of not only primary but also secondary harm of the pandemic and to find right definitions and momentum to restore the transplant programs.

journal_name

Transpl Immunol

journal_title

Transplant immunology

authors

de Vries APJ,Alwayn IPJ,Hoek RAS,van den Berg AP,Ultee FCW,Vogelaar SM,Haase-Kromwijk BJJM,Heemskerk MBA,Hemke AC,Nijboer WN,Schaefer BS,Kuiper MA,de Jonge J,van der Kaaij NP,Reinders MEJ

doi

10.1016/j.trim.2020.101304

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

101304

eissn

0966-3274

issn

1878-5492

pii

S0966-3274(20)30078-2

journal_volume

61

pub_type

社论

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