Impact on the Solid Organ Transplant Waiting List During the Covid-19 Pandemic: An Integrative Review

Costa, Ludmila Rodrigues Oliveira; Furtado, Ludmila Cristina Camilo; Braga, Renan Camilo; Brito, Bruna Dyana Batista; Sales, Thiago Joanes Brandao; Motta, Daniela de Lucena; Nunes, Felipe Henrique Santos; Schmidt, Yasmin Fontes; Silva, Hugo Rafael de Souza e; Fonseca Neto, Olival Cirilo Lucena da

doi:10.53855/bjt.v26i1.477_PORT

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REVIEW ARTICLE • Braz. J. Transplant. 26 • 2023 • https://doi.org/10.53855/bjt.v26i1.477_ENG linkcopy

Impact on the Solid Organ Transplant Waiting List During the Covid-19 Pandemic: An Integrative Review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Introduction: With the Covid-19 pandemic, many medical procedures underwent significant changes due to the reallocation of resources to patients infected with Sars-Cov-2. The logistics of transplants were directly affected, with important repercussions for the patient on the waiting list for a new organ. Objective: This review seeks to analyze the impact of the Covid-19 pandemic on the logistics of solid organ availability and volume of transplants.

Methods: An integrative search of articles with the descriptors “Covid OR Sars-Cov-2”, “COVID-19”, “Transplant”, “Donor”, “Waiting list”, and “Organ donation” in PubMed and Web of Science was performed. Only articles on pancreas, heart, liver, kidney and intestine transplantation that addressed one of the following topics were considered: availability of donors, volume and time on the waiting list, mortality of patients on the waiting list, and volume of transplants performed.

Results: Of the 68 articles found, 49 of them were multicentric. Among all 68, 29 made a statement concerning donor volume, 42 concerning transplant volume, 18 about mortality on the transplant waiting list, 15 concerning the volume on the waiting list, and 4 regarding time on the waiting list. Thus, with such data, in general, it was possible to observe a decrease in the volume of donors and the volume of transplants, besides a reduction in addition to the waiting list and an increase both in the waiting time for transplantation and in the mortality of the patients waiting for the transplant.

Conclusion: The SARS-CoV-2 pandemic has directly influenced the logistics of solid organ transplants globally. The reasons that led to this fact are related to the decrease in the availability of ICU beds, contamination of the donor by the virus, and strict protocols to prevent the transmission of the virus.

Keywords
Covid; Organ Transplantation; Pandemic; Organ Donation

Variable	Waiting list mortality
Increase	Charnaya et al. (2021)⁴	Belli et al. (2021)¹⁴	Hudgins et al. (2021)⁴⁵
	Chew et al. (2020)⁵	Strauss et al. (2021)²⁰	Ito et al. (2022)⁴⁷
	Boyarsky et al. (2020)⁶	Hardman et al. (2021)²¹	Mamode et al. (2021)⁵¹
	Russo et al. (2022)⁸	Peters et al. (2021)⁴⁰
	Miller et al. (2021)⁹	Goff et al. (2021)⁴²
Decrease	-	-	-
Unchanged	Benvenuto et al. (2021)¹¹	Saracco et al. (2021)³⁰	Boedecker et al. (2021)³¹
Unchanged	Karolak et al. (2021)¹⁵
Not specified	Maggi et al. (2020)¹	Simone et al. (2020)²⁸	Bordes et al. (2020)⁵²
	Servin-Rojas et al. (2021)²	Pestana et al. (2021)²⁹	Hardman et al. (2021)⁵³
	Boyarsky et al. (2020)³	Anderson et al. (2021)³²	Bhatti et al. (2021)⁵⁴
	Chan et al. (2021)⁷	Sahin et al. (2022)³³	Cristelli et al. (2021)⁵⁵
	Reddy et al. (2020)¹⁰	Caliskan et al. (2022)³⁴	Caliskan et al. (2021)⁵⁶
	Kemme et al. (2021)¹²	Araújo et al. (2020)³⁵	Thind et al. (2021)⁵⁷
	Georgiades et al. (2021)¹³	Ahmed et al. (2020)³⁶	Arias-Murillo et al. (2021)⁵⁸
	Sharma et al. (2020)¹⁶	Muller et al. (2020)³⁷	Turco et al. (2021)⁵⁹
	Bittermann et al. (2021)¹⁷	Xu et al. (2021)³⁸	Ravanan et al. (2020)⁶⁰
	Ribeiro Junior et al. (2021)¹⁸	Couzi et al. (2021)³⁹	Cheung et al. (2021)⁶¹
	Filippis et al. (2020)¹⁹	Vries et al. (2020)⁴¹	Manzia et al. (2021)⁶²
	Watschinger et al. (2020)²²	Immer et al. (2020)⁴³	Varghese et al. (2021)⁶³
	Halpern et al. (2020)²³	Cannavò et al. (2020)⁴⁴	Cristelli et al. (2022)⁶⁴
	Balsara et al. (2021)²⁴	Angelico et al. (2020)⁴⁶	Doshi et al. (2021)⁶⁵
	Ashfaq et al. (2021)²⁵	Soin et al. (2021)⁴⁸	Strauss et al. (2020)⁶⁶
	Dogar et al. (2021)²⁶	González-Vílchez et al. (2021)⁴⁹	Meshram et al. (2022)⁶⁷
	Varma et al. (2021)²⁷	Benden et al. (2020)⁵⁰	Tan et al. (2021)⁶⁸
Variable	Donor availability
Increase	Russo et al. (2022)⁸	Georgiades et al. (2021)¹³	Ashfaq et al. (2021)²⁵**
Decrease	Maggi et al. (2020)¹	Strauss et al. (2021)²⁰	Hudgins et al. (2021)⁴⁵
	Boyarsky et al. (2020)⁶	Hardman et al. (2021)²¹	Ito et al. (2022)⁴⁷
	Chan et al. (2021)⁷	Saracco et al. (2021)³⁰	Bordes et al. (2020)⁵²
	Reddy et al. (2020)¹⁰	Sahin et al. (2022)³³	Hardman et al. (2021)⁵³
	Benvenuto et al. (2021)¹¹	Araújo et al. (2020)³⁵	Caliskan et al. (2021)⁵⁶
	Sharma et al. (2020)¹⁶	Xu et al. (2021)³⁸	Turco et al. (2021)⁵⁹
	Ribeiro Junior et al. (2021)¹⁸	Goff et al. (2021)⁴²	Cheung et al. (2021)⁶¹
Unchanged	Kemme et al. (2021)¹²	Dogar et al. (2021)²⁶
Unchanged	Karolak et al. (2021)¹⁵	Varma et al. (2021)²⁷
Not specified	Servin-Rojas et al. (2021)²	Anderson et al. (2021)³²	Bhatti et al. (2021)⁵⁴
	Boyarsky et al. (2020)³	Caliskan et al. (2022)³⁴	Cristelli et al. (2021)⁵⁵
	Charnaya et al. (2021)⁴	Ahmed et al. (2020)³⁶	Thind et al. (2021)⁵⁷
	Chew et al. (2020)⁵	Muller et al. (2020)³⁷	Arias-Murillo et al. (2021)⁵⁸
	Miller et al. (2021)⁹	Couzi et al. (2021)³⁹	Ravanan et al. (2020)⁶⁰
	Belli et al. (2021)¹⁴	Peters et al. (2021)⁴⁰	Manzia et al. (2021)⁶²
	Bittermann et al. (2021)¹⁷	Vries et al. (2020)⁴¹	Varghese et al. (2021)⁶³
	Filippis et al. (2020)¹⁹	Immer et al. (2020)⁴³	Cristelli et al. (2022)⁶⁴
	Watschinger et al. (2020)²²	Cannavò et al. (2020)⁴⁴	Doshi et al. (2021)⁶⁵
	Halpern et al. (2020)²³	Angelico et al. (2020)⁴⁶	Strauss et al. (2020)⁶⁶
	Balsara et al. (2021)²⁴	Soin et al. (2021)⁴⁸	Meshram et al. (2022)⁶⁷
	Simone et al. (2020)²⁸	González-Vílchez et al. (2021)⁴⁹	Tan et al. (2021)⁶⁸
	Pestana et al. (2021)²⁹	Benden et al. (2020)⁵⁰
	Boedecker et al. (2021)³¹	Mamode et al. (2021)⁵¹
Variable	Waiting list time
Increase	Kemme et al. (2021)¹²	Ashfaq et al. (2021)²⁵**	Strauss et al. (2020)⁶⁶
Decrease	Ashfaq et al. (2021)²⁵**
Unchanged	Ribeiro Junior et al. (2021)¹⁸
Not specified	Maggi et al. (2020)¹	Dogar et al. (2021)²⁶	Ito et al. (2022)⁴⁷
	Servin-Rojas et al. (2021)²	Varma et al. (2021)²⁷	Soin et al. (2021)⁴⁸
	Boyarsky et al. (2020)³	Simone et al. (2020)²⁸	González-Vílchez et al. (2021)⁴⁹
	Charnaya et al. (2021)⁴	Pestana et al. (2021)²⁹	Benden et al. (2020)⁵⁰
	Chew et al. (2020)⁵	Saracco et al. (2021)³⁰	Mamode et al. (2021)⁵¹
	Boyarsky et al. (2020)⁶	Boedecker et al. (2021)³¹	Bordes et al. (2020)⁵²
	Chan et al. (2021)⁷	Anderson et al. (2021)³²	Hardman et al. (2021)⁵³
	Russo et al. (2022)⁸	Sahin et al. (2022)³³	Bhatti et al. (2021)⁵⁴
	Miller et al. (2021)⁹	Caliskan et al. (2022)³⁴	Cristelli et al. (2021)⁵⁵
Not specified	Reddy et al. (2020)¹⁰	Araújo et al. (2020)³⁵	Caliskan et al. (2021)⁵⁶
	Benvenuto et al. (2021)¹¹	Ahmed et al. (2020)³⁶	Thind et al. (2021)⁵⁷
	Georgiades et al. (2021)¹³	Muller et al. (2020)³⁷	Arias-Murillo et al. (2021)⁵⁸
	Belli et al. (2021)¹⁴	Xu et al. (2021)³⁸	Turco et al. (2021)⁵⁹
	Karolak et al. (2021)¹⁵	Couzi et al. (2021)³⁹	Ravanan et al. (2020)⁶⁰
	Sharma et al. (2020)¹⁶	Peters et al. (2021)⁴⁰	Cheung et al. (2021)⁶¹
	Bittermann et al. (2021)¹⁷	Vries et al. (2020)⁴¹	Manzia et al. (2021)⁶²
	Filippis et al. (2020)¹⁹	Goff et al. (2021)⁴²	Varghese et al. (2021)⁶³
	Strauss et al. (2021)²⁰	Immer et al. (2020)⁴³	Cristelli et al. (2022)⁶⁴
	Hardman et al. (2021)²¹	Cannavò et al. (2020)⁴⁴	Doshi et al. (2021)⁶⁵
	Watschinger et al. (2020)²²	Hudgins et al. (2021)⁴⁵	Meshram et al. (2022)⁶⁷
	Halpern et al. (2020)²³	Angelico et al. (2020)⁴⁶	Tan et al. (2021)⁶⁸
Variable	Number of candidates on the transplant waiting list
Increase	Russo et al. (2022)⁸**	Sharma et al. (2020)¹⁶	Anderson et al. (2021)³²
Increase	Karolak et al. (2021)¹⁵	Bittermann et al. (2021)¹⁷	Muller et al. (2020)³⁷
Decrease	Chan et al. (2021)⁷	Hardman et al. (2021)²¹	Meshram et al. (2022)⁶⁷
	Russo et al. (2022)⁸**	Goff et al. (2021)⁴²	Tan et al. (2021)⁶⁸
	Filippis et al. (2020)¹⁹	Hardman et al. (2021)⁵³
	Strauss et al. (2021)²⁰	Manzia et al. (2021)⁶²
Unchanged	Watschinger et al. (2020)²²
Not specified	Maggi et al. (2020)¹	Simone et al. (2020)²⁸	González-Vílchez et al. (2021)⁴⁹
	Servin-Rojas et al. (2021)²	Pestana et al. (2021)²⁹	Benden et al. (2020)⁵⁰
	Boyarsky et al. (2020)³	Saracco et al. (2021)³⁰	Mamode et al. (2021)⁵¹
	Charnaya et al. (2021)⁴	Boedecker et al. (2021)³¹	Bordes et al. (2020)⁵²
	Chew et al. (2020)⁵	Sahin et al. (2022)³³	Bhatti et al. (2021)⁵⁴
	Boyarsky et al. (2020)⁶	Caliskan et al. (2022)³⁴	Cristelli et al. (2021)⁵⁵
	Miller et al. (2021)⁹	Araújo et al. (2020)³⁵	Caliskan et al. (2021)⁵⁶
	Reddy et al. (2020)¹⁰	Ahmed et al. (2020)³⁶	Thind et al. (2021)⁵⁷
	Benvenuto et al. (2021)¹¹	Xu et al. (2021)³⁸	Arias-Murillo et al. (2021)⁵⁸
	Kemme et al. (2021)¹²	Couzi et al. (2021)³⁹	Turco et al. (2021)⁵⁹
	Georgiades et al. (2021)¹³	Peters et al. (2021)⁴⁰	Ravanan et al. (2020)⁶⁰
	Belli et al. (2021)¹⁴	Vries et al. (2020)⁴¹	Cheung et al. (2021)⁶¹
	Ribeiro Junior et al. (2021)¹⁸	Immer et al. (2020)⁴³	Varghese et al. (2021)⁶³
	Halpern et al. (2020)²³	Cannavò et al. (2020)⁴⁴	Cristelli et al. (2022)⁶⁴
	Balsara et al. (2021)²⁴	Hudgins et al. (2021)⁴⁵	Doshi et al. (2021)⁶⁵
	Ashfaq et al. (2021)²⁵	Angelico et al. (2020)⁴⁶	Strauss et al. (2020)⁶⁶
	Dogar et al. (2021)²⁶	Ito et al. (2022)⁴⁷
	Varma et al. (2021)²⁷	Soin et al. (2021)⁴⁸
Variable	Transplant volume
Increase	Russo et al. (2022)⁸**	Balsara et al. (2021)²⁴	Pestana et al. (2021)²⁹**
	Bittermann et al. (2021)¹⁷	Ashfaq et al. (2021)²⁵	Cristelli et al. (2021)⁵⁵
	Halpern et al. (2020)²³	Dogar et al. (2021)²⁶
Decrease	Servin-Rojas et al. (2021)²	Filippis et al. (2020)¹⁹	Hudgins et al. (2021)⁴⁵
	Boyarsky et al. (2020)³	Strauss et al. (2021)²⁰	Angelico et al. (2020)⁴⁶
	Charnaya et al. (2021)⁴	Hardman et al. (2021)²¹	Ito et al. (2022)⁴⁷
	Boyarsky et al. (2020)⁶	Simone et al. (2020)²⁸	González-Vílchez et al. (2021)⁴⁹
	Chan et al. (2021)⁷	Pestana et al. (2021)²⁹**	Hardman et al. (2021)⁵³
	Russo et al. (2022)⁸	Caliskan et al. (2022)³⁴	Bhatti et al. (2021)⁵⁴
	Reddy et al. (2020)¹⁰	Ahmed et al. (2020)³⁶	Thind et al. (2021)⁵⁷
	Benvenuto et al. (2021)¹¹	Muller et al. (2020)³⁷	Turco et al. (2021)⁵⁹
	Kemme et al. (2021)¹²	Vries et al. (2020)⁴¹	Varghese et al. (2021)⁶³
	Georgiades et al. (2021)¹³	Immer et al. (2020)⁴³	Meshram et al. (2022)⁶⁷
	Ribeiro Junior et al. (2021)¹⁸	Cannavò et al. (2020)⁴⁴	Tan et al. (2021)⁶⁸
Unchanged	Varma et al. (2021)²⁷
Not specified	Maggi et al. (2020)¹	Sahin et al. (2022)³⁴	Caliskan et al. (2021)⁵⁶
	Chew et al. (2020)⁵	Araújo et al. (2020)³⁵	Arias-Murillo et al. (2021)⁵⁸
	Belli et al. (2021)¹⁴	Xu et al. (2021)³⁸	Ravanan et al. (2020)⁶⁰
	Karolak et al. (2021)¹⁵	Couzi et al. (2021)³⁹	Cheung et al. (2021)⁶¹
	Sharma et al. (2020)¹⁶	Peters et al. (2021)⁴⁰	Manzia et al. (2021)⁶²
	Watschinger et al. (2020)²²	Goff et al. (2021)⁴²	Doshi et al. (2021)⁶⁵
	Saracco et al. (2021)³⁰	Benden et al. (2020)⁵⁰	Strauss et al. (2020)⁶⁶
	Boedecker et al. (2021)³¹	Mamode et al. (2021)⁵¹
	Anderson et al. (2021)³²	Bordes et al. (2020)⁵²

Studies
Heart	Filippis et al. (2020)¹⁹	Ashfaq et al. (2021)²⁵	Hardman et al. (2021)⁵³
Heart	Balsara et al. (2021)²⁴	González-Vílchez et al. (2021)⁴⁹
Lung	Chan et al. (2021)⁷	Karolak et al. (2021)¹⁵	Halpern et al. (2020)²³
Lung	Benvenuto et al. (2021)¹¹	Hardman et al. (2021)²¹	Sahin et al. (2022)³³
Kidney	Charnaya et al. (2021)⁴	Boedecker et al. (2021)³¹	Thind et al. (2021)⁵⁷
	Boyarsky et al. (2020)⁶	Caliskan et al. (2022)³⁴	Manzia et al. (2021)⁶²
	Georgiades et al. (2021)¹³	Couzi et al. (2021)³⁹	Cristelli et al. (2022)⁶⁶
	Sharma et al. (2020)¹⁶	Peters et al. (2021)⁴⁰	Doshi et al. (2021)⁶⁵
	Watschinger et al. (2020)²²	Bordes et al. (2020)⁵²	Strauss et al. (2020)⁶⁶
	Pestana et al. (2021)²⁹	Cristelli et al. (2021)⁵⁵	Meshram et al. (2022)⁶⁷
Liver	Maggi et al. (2020)¹	Strauss et al. (2021)²⁰	Muller et al. (2020)³⁷
	Chew et al. (2020)⁵	Dogar et al. (2021)²⁶	Soin et al. (2021)⁴⁸
	Russo et al. (2022)⁸	Varma et al. (2021)²⁷	Bhatti et al. (2021)⁵⁴
	Reddy et al. (2020)¹⁰	Simone et al. (2020)²⁸	Turco et al. (2021)⁵⁹
	Kemme et al. (2021)¹²	Saracco et al. (2021)³⁰	Varghese et al. (2021)⁶³
	Belli et al. (2021)¹⁴	Anderson et al. (2021)³²	Tan et al. (2021)⁶⁸
	Bittermann et al. (2021)¹⁷	Araújo et al. (2020)³⁵
More than one organ	Servin-Rojas et al. (2021)²	Goff et al. (2021)⁴²	Mamode et al. (2021)⁵¹
	Boyarsky et al. (2020)³	Immer et al. (2020)⁴³	Caliskan et al. (2021)⁵⁶*
	Miller et al. (2021)⁹	Cannavò et al. (2020)⁴⁴	Arias-Murillo et al. (2021)⁵⁸
	Ribeiro Junior et al. (2021)¹⁸	Hudgins et al. (2021)⁴⁵*	Ravanan et al. (2020)⁶⁰
	Ahmed et al. (2020)³⁵	Angelico et al. (2020)⁴⁶	Cheung et al. (2021)⁶¹
	Xu et al. (2021)³⁸	Ito et al. (2022)⁴⁷
	Vries et al. (2020)⁴¹	Benden et al. (2020)⁵⁰

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[1] Source: Elaborated by the authors.

Monocentric	Georgiades et al. (2021)¹³	Saracco et al. (2021)³⁰	Balsara et al. (2021)²⁴
	Karolak et al. (2021)¹⁵	Boedecker et al. (2021)³¹	Soin et al. (2021)⁴⁸
	Halpern et al. (2020)²³	Sahin et al. (2022)³³	Bhatti et al. (2021)⁵⁴
	Dogar et al. (2021)²⁶	Araújo et al. (2020)³⁵	Cristelli et al. (2021)⁵⁵
	Varma et al. (2021)²⁷	Muller et al. (2020)³⁷	Caliskan et al. (2021)⁵⁶
	Simone et al. (2020)²⁸	Xu et al. (2021)³⁸	Cheung et al. (2021)⁶¹
	Pestana et al. (2021)²⁹	Hudgins et al. (2021)⁴⁵	Manzia et al. (2021)⁶²
Multicentric	Maggi et al. (2020)¹	Ribeiro Junior et al. (2021)¹⁸	Ito et al. (2022)⁴⁷
	Servin-Rojas et al. (2021)²	Filippis et al. (2020)¹⁹	González-Vílchez et al. (2021)⁴⁹
	Boyarsky et al. (2020)³	Strauss et al. (2021)²⁰	Mamode et al. (2021)⁵¹
	Charnaya et al. (2021)⁴	Watschinger et al. (2020)²²	Bordes et al. (2020)⁵²
	Chew et al. (2020)⁵	Ashfaq et al. (2021)²⁵	Hardman et al. (2021)⁵³
	Boyarsky et al. (2020)⁶	Anderson et al. (2021)³²	Thind et al. (2021)⁵⁷
	Chan et al. (2021)⁷	Caliskan et al. (2022)³⁴	Arias-Murillo et al. (2021)⁵⁸
	Russo et al. (2022)⁸	Ahmed et al. (2020)³⁶	Turco et al. (2021)⁵⁹
	Miller et al. (2021)⁹	Couzi et al. (2021)³⁹	Ravanan et al. (2020)⁶⁰
	Reddy et al. (2020)¹⁰	Peters et al. (2021)⁴⁰	Varghese et al. (2021)⁶³
	Benvenuto et al. (2021)¹¹	Vries et al. (2020)⁴¹	Cristelli et al. (2022)⁶⁴
	Kemme et al. (2021)¹²	Goff et al. (2021)⁴²	Doshi et al. (2021)⁶⁵
	Belli et al. (2021)¹⁴	Immer et al. (2020)⁴³	Strauss et al. (2020)⁶⁶
	Sharma et al. (2020)¹⁶	Cannavò et al. (2020)⁴⁴	Meshram et al. (2022)⁶⁷
	Bittermann et al. (2021)¹⁷	Angelico et al. (2020)⁴⁶	Tan et al. (2021)⁶⁸