The impact of the SARS‐CoV‐2 pandemic and COVID‐19 on lung transplantation in the UK: Lessons learned from the first wave

Abstract

Background Lung transplantation is particularly susceptible to the impact of the severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) pandemic, and evaluation of changes to practice is required to inform future decision‐making. Methods A retrospective review of the UK Transplant Registry (UKTR) and national survey of UK lung transplant centers has been performed. Results There was geographic variation in the prevalence of COVID‐19 infection across the UK. The number of donors fell by 48% during the early pandemic period. Lung utilization fell to 10% (compared with 24% for the same period of 2019). The number of lung transplants performed fell by 77% from 53, March to May 2019, to 12. Seven (58%) of these were performed in a single‐center, designated “COVID‐light.” The number of patients who died on the lung transplant waiting list increased, compared to the same period of 2019 ( p = .0118). Twenty‐six lung transplant recipients with confirmed COVID‐19 infection were reported during the study period. Conclusion As the pandemic continues, reviewing practice and implementing the lessons learned during this period, including the use of robust donor testing strategies and the provision of “COVID‐light” hospitals, are vital in ensuring the safe continuation of our lung transplant program.

The changing landscape of pediatric lung transplantation

“…Solid organ transplantation activity was curtailed at national levels due to the pandemic; in Canada for instance, there was a 14% reduction in solid organ transplants performed in 2020, with an 11% reduction in deceased solid organ donation and 21% reduction in living donation nation‐wide compared to the previous year 9 . Data from the United Kingdom followed a similar trend, showing a fall of 77% in the number of adult lung transplants performed in mid‐2020 compared to the previous year 10 . In other countries, however, the effect of the COVID‐19 pandemic on LTX has been less pronounced.…”

“…9 Data from the United Kingdom followed a similar trend, showing a fall of 77% in the number of adult lung transplants performed in mid-2020 compared to the previous year. 10 In other countries, however, the effect of the COVID-19 pandemic on LTX has been less pronounced. Overall transplant activity in Germany remained similar with versus 2010-2018 (Figure 3).…”

Clinical relevance of lung transplantation for COVID-19 ARDS: a nationwide study

“…With an increasing number of lung transplant centers offering transplantation to post-COVID-19 ARDS patients, ethical concerns have been raised if the high urgency status is justified in these patients. Especially during the first wave of the pandemic, donation rates dropped dramatically resulting in an increasing wait list mortality for “traditional” LTx indications such as chronic obstructive pulmonary disease, interstitial lung disease, cystic fibrosis, pulmonary arterial hypertension [ 26 , 27 ]. In the study period, median time on waiting list was 40 days for all LTx candidates listed in Austria.…”

SARS-CoV-2 and lung transplantation. What do we know?

“…The early phase of the Covid-19 pandemic reduced the number of lung transplantations performed [35]. Consequently, more patients are on the waiting list and more deaths among those patients has occurred [36]. This systematic review should be considered with several limitations.…”