Impact of COVID-19 on Liver Transplant Activity in the USA: Variation by Etiology and Cirrhosis Complications  

作　　者：Yong-Fang Kuo Paul Kwo Robert J Wong Ashwani K.Singal 

机构地区：[1]Department of Biostatistics,University of Texas Medical Branch,Galveston,TX,USA [2]Division of Gastroenterology and Hepatology,Veterans Affairs Palo Alto Healthcare System,Stanford University School of Medicine,Palo Alto,CA,USA [3]University of South Dakota Sanford,School of Medicine,Vermillion,SD,USA [4]Avera Transplant Institute,Sioux Falls,SD,USA

出　　处：《Journal of Clinical and Translational Hepatology》2023年第1期130-135,共6页临床与转化肝病杂志（英文版）

摘　　要：Background and Aims:The COVID-19 pandemic has impacted the care of patients with liver disease.We examined impact of COVID-19 on liver transplant(LT)activity in the USA.Methods:LT listings in the United Network for Organ Sharing(UNOS)database(April 2018–May 2021)were analyzed to examine the impact of COVID-19 pandemic on the LT activity based on etiology:hepatitis C virus(HCV),alcohol-associated liver disease(ALD),alcoholic hepatitis(AH),and nonalcoholic steatohepatitis(NASH)complications:hepatocellular carcinoma(HCC)and acute-on-chronic liver failure(ACLF)grade 2 or 3 and Model for End-Stage Liver Disease(MELD)score.Joinpoint regression models assessed time trend changes on a log scale.Results:Of 23,871 recipients(8,995 in the COVID era,April 2018–February 2020),mean age 52 years,62% men,61% Caucasian,32%ALD,15%HCC,30%ACLF grades 2–3,and mean MELD score 20.5,monthly LT changes were a decrease of 3.4%for overall LTs and 22%for HCC after September 2020,and increase of 4.5%for ALD since 11/2020 and 17%since 03/2021 for ACLF grade 2–3.Monthly MELD scores increased by 0.7 and 0.36 after June 2020 for HCV and HCC respectively.Conclusions:The COVID-19 pandemic has impacted LT activity,with a decrease of LTs especially for HCC,and an increase of LTs for ALD and severe ACLF.Strategies are needed to reorganize cirrhosis patients to overcome the aftereffects of COVID-19 pandemic.

关 键 词：COVID-19 UNOS OLT Region Public policies 

分 类 号：R575.2[医药卫生—消化系统]