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A coordinated national UK liver transplant program response, prioritizing waitlist recipients with the highest need, provided excellent outcomes during the first wave of the COVID-19 pandemic

Lookup NU author(s): Dr Steven MassonORCiD, Professor Derek Manas


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© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.Introduction: Healthcare provision has been severely affected by COVID-19, with specific challenges in organ transplantation. Here, we describe the coordinated response to, and outcomes during the first wave, across all UK liver transplant (LT) centers. Methods: Several policy changes affecting the liver transplant processes were agreed upon. These included donor age restrictions and changes to offering. A “high-urgency” (HU) category was established, prioritizing only those with UKELD > 60, HCC reaching transplant criteria, and others likely to die within 90 days. Outcomes were compared with the same period in 2018 and 2019. Results: The retrieval rate for deceased donor livers (71% vs. 54%; P <.0001) and conversion from offer to completed transplant (63% vs. 48%; P <.0001) was significantly higher. Pediatric LT activity was maintained; there was a significant reduction in adult (42%) and total (36%) LT. Almost all adult LT were super-urgent (n = 15) or HU (n = 133). We successfully prioritized those with highest illness severity with no reduction in 90-day patient (P =.89) or graft survival (P =.98). There was a small (5% compared with 3%; P =.0015) increase in deaths or removals from the waitlist, mainly amongst HU cohort. Conclusions: We successfully prioritized LT recipients in highest need, maintaining excellent outcomes, and waitlist mortality was only marginally increased.

Publication metadata

Author(s): Masson S, Taylor R, Whitney J, Adair A, Attia M, Gibbs P, Grammatikopoulos T, Isaac J, Marshall A, Mirza D, Prachalias A, Watson S, Manas D, Forsythe J, Thorburn D

Publication type: Article

Publication status: Published

Journal: Clinical Transplantation

Year: 2021

Volume: 36

Issue: 4

Online publication date: 16/12/2021

Acceptance date: 12/12/2021

ISSN (print): 0902-0063

ISSN (electronic): 1399-0012

Publisher: John Wiley and Sons Inc


DOI: 10.1111/ctr.14563


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