Panic in the Pandemic: When Should Kidney Transplant Programs Close?

Area of Science:

• Nephrology
• Transplant Surgery
• Public Health

Background:

• Pandemics disrupt healthcare, diverting resources and leading to temporary closures of vital programs like kidney transplantation.
• The critical shortage and short shelf-life of deceased donor organs underscore the importance of analyzing organ discard impacts.

Purpose of the Study:

• To evaluate the net benefit or harm of discarding deceased donor organs during a pandemic.
• To assess the impact on patient life expectancy from both societal and individual perspectives.

Main Methods:

• A Markov model was utilized to project life years gained or lost.
• Analysis incorporated a range of infection rates, pandemic durations, and case fatality rates.

Main Results:

• Patient life expectancy decreased under unfavorable pandemic conditions for both wait-listed and transplant recipients.
• Despite a reduction, the net benefit of kidney transplantation over dialysis was preserved, remaining over 4 years for most deceased donor organs.
• For a 40-year-old, pre-pandemic net benefit was 6.25 life years (LYs), falling to 5.86 LYs during the pandemic.

Conclusions:

• Kidney transplantation should continue even during pandemics, provided healthcare systems have sufficient resources.
• Limiting nosocomial (hospital-acquired) infections is crucial for maintaining the safety and efficacy of transplantation during health crises.