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Kidney Week

Abstract: PO0769

Living Donor Kidney Transplant Practice in the COVID-19 Era: A Survey of US Transplant Programs

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Lentine, Krista L., Saint Louis University, Saint Louis, Missouri, United States
  • Vest, Luke S., Saint Louis University, Saint Louis, Missouri, United States
  • Schnitzler, Mark, Saint Louis University, Saint Louis, Missouri, United States
  • Mannon, Roslyn B., University of Nebraska Omaha, Omaha, Nebraska, United States
  • Kumar, Vineeta, The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Doshi, Mona D., University of Michigan, Ann Arbor, Michigan, United States
  • Cooper, Matthew, MedStar Georgetown University Hospital, Washington, District of Columbia, United States
  • Mandelbrot, Didier A., University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Harhay, Meera Nair, Drexel University, Philadelphia, Pennsylvania, United States
  • Josephson, Michelle A., University of Chicago, Chicago, Illinois, United States
  • Kasiske, Bertram L., Hennepin County, Minneapolis, Minnesota, United States
  • Caliskan, Yasar, Saint Louis University, Saint Louis, Missouri, United States
  • Axelrod, David, University of Iowa, Iowa City, Iowa, United States
Background

We surveyed U.S. transplant programs to assess practices, strategies and barriers related to living donor kidney transplantation (LDKT) in the context of the COVID-19 pandemic.

Methods

After IRB approval, the survey was launched 5/9/20 by email and postings to professional society list-servs, using the Qualtrics platform. Data are reported through 5/27/20, and examined by state COVID-19 prevalence.

Results

Staff at 117 unique centers responded, representing 58% of U.S. living donor recovery centers and 75% of LKDT volume in the year before pandemic declaration. Overall, 66% reported LDKT surgery was on hold (82% in high vs. 50% in low prevalence states). 36% reported that evaluation of new donor candidates had paused, 27% reported evaluations were very decreased (>0% to <25% typical) and 23% reported evaluations were moderately decreased (25% to <50% typical). Barriers to LDKT surgery included program concerns for donor (84%) and recipient (75%) safety, patients concerns (54%), restrictions on elective cases (47%) and hospital administrative restrictions (47%). Programs with higher local COVID-19 prevalence reported more barriers related to staff and resource diversion (Figure).
Most centers continuing donor evaluations used remote strategies (video 82%; telephone 43%). 61% of centers plan to continue more telehealth after the pandemic. 32% plan to resume some LDKT within 2 wks and 27% within 1 month. When surgery resumes, all will screen for COVID-19 before donation surgery, although timeframe and modalities vary.

Conclusion

COVID-19 has created many barriers to LDKT, especially in areas of highest prevalence. Transplant centers are planning to restart LKDT cautiously. Consensus-building is needed to reduce barriers, guide optimal practice, and facilitate safe restoration of LDKT across centers.

Barriers to LDKT during COVID-19 pandemic