Changes in the liver transplant evaluation process during the early COVID-19 era and the role of telehealth  

作　　者：Ashley H Jowell Allison J Kwong Reshma Reguram Tami J Daugherty Paul Yien Kwo 

机构地区：[1]Department of Medicine,Duke University Medical Center,Durham,NC 27710,United States [2]Department of Medicine,Stanford University,Redwood City,CA 94063,United States [3]Department of Medicine,Trinity Health,Pontiac,MI 48341,United States

出　　处：《World Journal of Transplantation》2025年第2期149-160,共12页世界移植杂志(英文)

摘　　要：BACKGROUND Coronavirus disease 2019(COVID-19)disrupted healthcare and led to increased telehealth use.We explored the impact of COVID-19 on liver transplant evaluation(LTE).AIM To understand the impact of telehealth on LTE during COVID-19 and to identify disparities in outcomes disaggregated by sociodemographic factors.METHODS This was a retrospective study of patients who initiated LTE at our center from 3/16/20-3/16/21(“COVID-19 era”)and the year prior(3/16/19-3/15/20,“pre-COVID-19 era”).We compared LTE duration times between eras and explored the effects of telehealth and inpatient evaluations on LTE duration,listing,and pretransplant mortality.RESULTS One hundred and seventy-eight patients were included in the pre-COVID-19 era cohort and one hundred and ninety-nine in the COVID-19 era cohort.Twentynine percent(58/199)of COVID-19 era initial LTE were telehealth,compared to 0%(0/178)pre-COVID-19.There were more inpatient evaluations during COVID-19 era(40%vs 28%,P<0.01).Among outpatient encounters,telehealth use for initial LTE during COVID-19 era did not impact likelihood of listing,pretransplant mortality,or time to LTE and listing.Median times to LTE and listing during COVID-19 were shorter than pre-COVID-19,driven by increased inpatient evaluations.Sociodemographic factors were not predictive of telehealth.CONCLUSION COVID-19 demonstrates a shift to telehealth and inpatient LTE.Telehealth does not impact LTE or listing duration,likelihood of listing,or mortality,suggesting telehealth may facilitate LTE without negative outcomes.

关 键 词：Liver transplant evaluation TELEHEALTH Health access Health equity COVID-19 

分 类 号：TN9[电子电信—信息与通信工程]