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26.09.2020 | COVID-19 | Original Article Zur Zeit gratis

Effects of COVID-19 pandemic on pediatric kidney transplant in the United States

verfasst von: Olga Charnaya, Teresa Po-Yu Chiang, Richard Wang, Jennifer D. Motter, Brian J. Boyarsky, Elizabeth A. King, William A. Werbel, Christine M. Durand, Robin K. Avery, Dorry L. Segev, Allan B. Massie, Jacqueline M. Garonzik-Wang

Erschienen in: Pediatric Nephrology | Ausgabe 1/2021

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Abstract

Background

In March 2020, COVID-19 infections began to rise exponentially in the USA, placing substantial burden on the healthcare system. As a result, there was a rapid change in transplant practices and policies, with cessation of most procedures. Our goal was to understand changes to pediatric kidney transplantation (KT) at the national level during the COVID-19 epidemic.

Methods

Using SRTR data, we examined changes in pediatric waitlist registration, waitlist removal or inactivation, and deceased donor and living donor (DDKT/LDKT) events during the start of the disease transmission in the USA compared with the same time the previous year.

Results

We saw an initial decrease in DDKT and LDKT by 47% and 82% compared with expected events and then a continual increase, with numbers reaching expected prepandemic levels by May 2020. In the early phase of the pandemic, waitlist inactivation and removals due to death or deteriorating condition rose above expected values by 152% and 189%, respectively. There was a statistically significant decrease in new waitlist additions (IRR _0.49 0.65 _0.85) and LDKT (IRR _0.17 0.38 _0.84) in states with high vs. low COVID activity. Transplant recipients during the pandemic were more likely to have received a DDKT, but had similar calculated panel–reactive antibody (cPRA) values, waitlist time, and cause of kidney failure as before the pandemic.

Conclusions

The COVID-19 pandemic initially reduced access to kidney transplantation among pediatric patients in the USA but has not had a sustained effect.

Amaral S, Sayed BA, Kutner N, Patzer RE (2016) Preemptive kidney transplantation is associated with survival benefits among pediatric patients with end-stage renal disease. Kidney Int 90:1100–1108. https://doi.org/10.1016/j.kint.2016.07.028CrossRefPubMedPubMedCentral

Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, Spitters C, Ericson K, Wilkerson S, Tural A, Diaz G, Cohn A, Fox L, Patel A, Gerber SI, Kim L, Tong S, Lu X, Lindstrom S, Pallansch MA, Weldon WC, Biggs HM, Uyeki TM, Pillai SK (2020) First case of 2019 novel coronavirus in the United States. N Engl J Med 382:929–936. https://doi.org/10.1056/NEJMoa2001191CrossRefPubMedPubMedCentral

Michaels MG, La Hoz RM, Danziger-Isakov L, Blumberg EA, Kumar D, Green M, Pruett TL, Wolfe CR (2020) Coronavirus disease 2019: implications of emerging infections for transplantation. Am J Transplant. https://doi.org/10.1111/ajt.15832

Boyarsky BJ, Po-Yu Chiang T, Werbel WA, Durand CM, Avery RK, Getsin SN, Jackson KR, Kernodle AB, Van Pilsum Rasmussen SE, Massie AB, Segev DL, Garonzik-Wang JM (2020) Early impact of COVID-19 on transplant center practices and policies in the United States. Am J Transplant. https://doi.org/10.1111/ajt.15915

Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, Li J, Yao Y, Ge S, Xu G (2020) Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int 97:829–838. https://doi.org/10.1016/j.kint.2020.03.005CrossRefPubMedPubMedCentral

Fanelli V, Fiorentino M, Cantaluppi V, Gesualdo L, Stallone G, Ronco C, Castellano G (2020) Acute kidney injury in SARS-CoV-2 infected patients. Crit Care 24:155. https://doi.org/10.1186/s13054-020-02872-zCrossRefPubMedPubMedCentral

Banerjee D, Popoola J, Shah S, Ster IC, Quan V, Phanish M (2020) COVID-19 infection in kidney transplant recipients. Kidney Int 97:1076–1082. https://doi.org/10.1016/j.kint.2020.03.018CrossRefPubMedPubMedCentral

Man Z, Jing Z, Huibo S, Bin L, Fanjun Z (2020) Viral shedding prolongation in a kidney transplant patient with COVID-19 pneumonia. Am J Transplant. https://doi.org/10.1111/ajt.15996

Fishman JA, Grossi PA (2020) Novel Coronavirus-19 (COVID-19) in the immunocompromised transplant recipient: #Flatteningthecurve. Am J Transplant. https://doi.org/10.1111/ajt.15890

10.

Loupy A, Aubert O, Reese PP, Bastien O, Bayer F, Jacquelinet C (2020) Organ procurement and transplantation during the COVID-19 pandemic. Lancet 395:e95–e96. https://doi.org/10.1016/s0140-6736(20)31040-0CrossRefPubMedPubMedCentral

11.

Massie AB, Boyarsky BJ, Werbel WA, Bae S, Chow EK, Avery RK, Durand CM, Desai N, Brennan D, Garonzik-Wang JM, Segev DL (2020) Identifying scenarios of benefit or harm from kidney transplantation during the COVID-19 pandemic: a stochastic simulation and machine learning study. Am J Transplant. https://doi.org/10.1111/ajt.16117

12.

de Vries APJ, Alwayn IPJ, Hoek RAS, van den Berg AP, Ultee FCW, Vogelaar SM, Haase-Kromwijk B, Heemskerk MBA, Hemke AC, Nijboer WN, Schaefer BS, Kuiper MA, de Jonge J, van der Kaaij NP, Reinders MEJ (2020) Immediate impact of COVID-19 on transplant activity in the Netherlands. Transpl Immunol 61:101304. https://doi.org/10.1016/j.trim.2020.101304CrossRefPubMedPubMedCentral

13.

Zimmermann P, Curtis N (2020) Coronavirus infections in children including COVID-19: an overview of the epidemiology, clinical features, diagnosis, treatment and prevention options in children. Pediatr Infect Dis J 39:355–368. https://doi.org/10.1097/inf.0000000000002660CrossRefPubMedPubMedCentral

14.

Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, Tong S (2020) Epidemiology of COVID-19 among children in China. Pediatrics 145:e20200702. https://doi.org/10.1542/peds.2020-0702CrossRefPubMed

15.

Marlais M, Wlodkowski T, Vivarelli M, Pape L, Tönshoff B, Schaefer F, Tullus K (2020) The severity of COVID-19 in children on immunosuppressive medication. Lancet Child Adolesc Health 4:e17–e18. https://doi.org/10.1016/s2352-4642(20)30145-0CrossRefPubMedPubMedCentral

16.

Zachariah P, Johnson CL, Halabi KC, Ahn D, Sen AI, Fischer A, Banker SL, Giordano M, Manice CS, Diamond R, Sewell TB, Schweickert AJ, Babineau JR, Carter RC, Fenster DB, Orange JS, McCann TA, Kernie SG, Saiman L (2020) Epidemiology, clinical features, and disease severity in patients with coronavirus disease 2019 (COVID-19) in a children’s hospital in New York City, New York. JAMA Pediatr. https://doi.org/10.1001/jamapediatrics.2020.2430

17.

Melgosa M, Madrid A, Alvárez O, Lumbreras J, Nieto F, Parada E, Perez-Beltrán V (2020) SARS-CoV-2 infection in Spanish children with chronic kidney pathologies. Pediatr Nephrol. https://doi.org/10.1007/s00467-020-04597-1

18.

Weaver DJ Jr, Somers MJG, Martz K, Mitsnefes MM (2017) Clinical outcomes and survival in pediatric patients initiating chronic dialysis: a report of the NAPRTCS registry. Pediatr Nephrol 32:2319–2330. https://doi.org/10.1007/s00467-017-3759-4CrossRefPubMed

19.

Prezelin-Reydit M, Combe C, Harambat J, Jacquelinet C, Merville P, Couzi L, Leffondré K (2019) Prolonged dialysis duration is associated with graft failure and mortality after kidney transplantation: results from the French transplant database. Nephrol Dial Transplant 34:538–545. https://doi.org/10.1093/ndt/gfy039CrossRefPubMed

20.

Massie AB, Kucirka LM, Segev DL (2014) Big data in organ transplantation: registries and administrative claims. Am J Transplant 14:1723–1730. https://doi.org/10.1111/ajt.12777CrossRefPubMedPubMedCentral

21.

USAFACTS (2020) Coronavirus Stats & Data. https://usafacts.org/issues/coronavirus/. Accessed 26 Aug 2020

22.

Massie AB, Leanza J, Fahmy LM, Chow EKH, Desai NM, Luo X, King EA, Bowring MG, Segev DL (2016) A risk index for living donor kidney transplantation. Am J Transplant 16:2077–2084. https://doi.org/10.1111/ajt.13709CrossRefPubMedPubMedCentral

23.

Boyarsky BJ, Werbel WA, Durand CM, Avery RK, Jackson KR, Kernodle AB, Snyder J, Hirose R, Massie IM, Garonzik-Wang JM, Segev DL, Massie AB (2020) Early national and center-level changes to kidney transplantation in the United States during the COVID-19 epidemic. Am J Transplant. https://doi.org/10.1111/ajt.16167

24.

Molnar MZ, Bhalla A, Azhar A, Tsujita M, Talwar M, Balaraman V, Sodhi A, Kadaria D, Eason JD, Hayek SS, Coca SG, Shaefi S, Neyra JA, Gupta S, Leaf DE Kovesdy CP, STOP, -COVID Investigators (2020) Outcomes of critically ill solid organ transplant patients with COVID-19 in the United States. Am J Transplant. https://doi.org/10.1111/ajt.16280

25.

D’Antiga L (2020) Coronaviruses and immunosuppressed patients: the facts during the third epidemic. Liver Transpl 26:832–834. https://doi.org/10.1002/lt.25756CrossRefPubMed

26.

Bush R, Johns F, Acharya R, Upadhyay K (2020) Mild COVID-19 in a pediatric renal transplant recipient. Am J Transplant. https://doi.org/10.1111/ajt.16003

27.

Pathak EB, Salemi JL, Sobers N, Menard J, Hambleton IR (2020) COVID-19 in children in the United States: intensive care admissions, estimated total infected, and projected numbers of severe pediatric cases in 2020. J Public Health Manag Pract 26:325–333. https://doi.org/10.1097/phh.0000000000001190CrossRefPubMed

28.

UNOS (2020) Number of deceased donors recovered in the US by week. https://public.tableau.com/shared/8MW3ZBGK9?:toolbar=n&:display_count=n&:origin=viz_share_link&:embed=y. Accessed 6/23/2020

29.

Ikizler TA, Kliger AS (2020) Minimizing the risk of COVID-19 among patients on dialysis. Nat Rev Nephrol 16:311–313. https://doi.org/10.1038/s41581-020-0280-yCrossRefPubMedPubMedCentral

30.

Lew SQ, Sikka N (2019) Operationalizing Telehealth for home dialysis patients in the United States. Am J Kidney Dis 74:95–100. https://doi.org/10.1053/j.ajkd.2019.01.023CrossRefPubMed

31.

Verghese PS (2017) Pediatric kidney transplantation: a historical review. Pediatr Res 81:259–264. https://doi.org/10.1038/pr.2016.207CrossRefPubMed

Titel: Effects of COVID-19 pandemic on pediatric kidney transplant in the United States
verfasst von: Olga Charnaya
Teresa Po-Yu Chiang
Richard Wang
Jennifer D. Motter
Brian J. Boyarsky
Elizabeth A. King
William A. Werbel
Christine M. Durand
Robin K. Avery
Dorry L. Segev
Allan B. Massie
Jacqueline M. Garonzik-Wang
Publikationsdatum: 26.09.2020
Verlag: Springer Berlin Heidelberg
Schlagwort: COVID-19
Erschienen in: Pediatric Nephrology / Ausgabe 1/2021
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-020-04764-4

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Effects of COVID-19 pandemic on pediatric kidney transplant in the United States