Introduction COVID-19 has drastically impacted the transplant services, but there is limited understanding the discrepancy in COVID-19 impact over various regions of the world. Methods We have explored the global observatory for organ donation and transplantation (GODT) data for assessing the transplant number changes between the calendar year 2019(n = 157301) and 2020(129681). Results There was disproportionate impact of COVID-19 for different areas of the world. Globally, there was a decline of 17.5%, in which deceased donation, kidney (20.9%), pancreas (16.2%), lung (12.7%), liver (11.3%) and heart (8%) transplantation declined disproportionally in different regions of the world. While pandemic affected almost all geographic regions and nations, but China and USA were mostly able to recover from the initial halt of the transplant practices by the pandemic, so that there was a cumulative increase in transplant numbers. Conclusion Our data, shows that developing nations lagged behind and developed nations have been able to recover their transplantation programs in the pandemic. Further policy making and preparedness is required to safeguard the most vulnerable areas of the world to minimize the impact of any future pandemic in transplantation practices.

Background We aimed to analyze the humoral and cellular response to standard and booster (additional doses) COVID‐19 vaccination in solid organ transplantation (SOT) and the risk factors involved for an impaired response. Methods We did a systematic review and meta‐analysis of studies published up until January 11, 2022, that reported immunogenicity of COVID‐19 vaccine among SOT. The study is registered with PROSPERO, number CRD42022300547. Results Of the 1527 studies, 112 studies, which involved 15391 SOT and 2844 healthy controls, were included. SOT showed a low humoral response (effect size [ES]: 0.44 [0.40–0.48]) in overall and in control studies (log‐Odds‐ratio [OR]: −4.46 [−8.10 to −2.35]). The humoral response was highest in liver (ES: 0.67 [0.61–0.74]) followed by heart (ES: 0.45 [0.32–0.59]), kidney (ES: 0.40 [0.36–0.45]), kidney‐pancreas (ES: 0.33 [0.13–0.53]), and lung (0.27 [0.17–0.37]). The meta‐analysis for standard and booster dose (ES: 0.43 [0.39–0.47] vs. 0.51 [0.43–0.54]) showed a marginal increase of 18% efficacy. SOT with prior infection had higher response (ES: 0.94 [0.92–0.96] vs. ES: 0.40 [0.39–0.41]; p ‐value < .01). The seroresponse with mRNA‐12723 mRNA was highest 0.52 (0.40–0.64). Mycophenolic acid (OR: 1.42 [1.21–1.63]) and Belatacept (OR: 1.89 [1.3–2.49]) had highest risk for nonresponse. SOT had a parallelly decreased cellular response (ES: 0.42 [0.32–0.52]) in overall and control studies (OR: −3.12 [−0.4.12 to −2.13]). Interpretation Overall, SOT develops a suboptimal response compared to the general population. Immunosuppression including mycophenolic acid, belatacept, and tacrolimus is associated with decreased response. Booster doses increase the immune response, but further upgradation in vaccination strategy for SOT is required.

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