Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep 1;5(9):1048-1052.
doi: 10.1001/jamacardio.2020.2696.

Trends in US Heart Transplant Waitlist Activity and Volume During the Coronavirus Disease 2019 (COVID-19) Pandemic

Ersilia M DeFilippis  1 , Lauren Sinnenberg  2 , Nosheen Reza  3 , Michael M Givertz  2 , Michelle M Kittleson  4 , Veli K Topkara  1 , Maryjane A Farr  1
Affiliations

Trends in US Heart Transplant Waitlist Activity and Volume During the Coronavirus Disease 2019 (COVID-19) Pandemic

Ersilia M DeFilippis et al. JAMA Cardiol. .

Abstract

Importance: Solid organ transplants have declined significantly during the coronavirus disease (COVID-19) pandemic in the US. Limited data exist regarding changes in heart transplant (HT).

Objective: To describe national and regional trends in waitlist inactivations, waitlist additions, donor recovery, and HT volume during COVID-19.

Design, setting, and participants: This descriptive cross-sectional study used publicly available data from the United Network for Organ Sharing and US Centers for Disease Control and Prevention, using 8 prespecified United Network for Organ Sharing regions. Adult (18 years or older) HT candidates listed and deceased donors recovered between January 19 to May 9, 2020.

Exposures: COVID-19 pandemic.

Main outcomes and measures: Changes in waitlist inactivations, waitlist additions, deceased donor recovery, and transplant volumes from the pre-COVID-19 (January 19-March 15, 2020) to the COVID-19 era (March 15-May 9, 2020). Density mapping and linear regression with interrupted time series analysis were used to characterize changes over time and changes by region.

Results: During the COVID-19 era, there were 600 waitlist inactivations compared with 343 during the pre-COVID era (75% increase). Waitlist additions decreased from 637 to 395 (37% reduction). These changes were most profound in the Northeast and Great Lakes regions with high rates of COVID-19. Deceased donor recovery decreased by 26% from 1878 to 1395; the most significant decrease occurred in the North Midwest despite low COVID-19 prevalence. Heart transplant volumes were significantly reduced across all regions except the Northwest. The largest decrease was seen in the Northeast where COVID-19 case rates were highest. From the pre-COVID-19 era to the COVID-19 era, there was significant regional variation in waitlist additions (eg, 69% decrease in the Northeast vs 8.5% increase in the South Midwest; P < .001) and deceased donor recovery (eg, 41% decrease in North Midwest vs 16% decrease in South Midwest; P = .02).

Conclusions and relevance: Heart transplant volumes have been significantly reduced in recent months, even in regions with a lower prevalence of COVID-19 cases. This has been accompanied by increased waitlist inactivations, decreased waitlist additions, and decreased donor recovery. Future studies are needed to determine if the COVID-19 pandemic is associated with changes in waitlist mortality.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure 1.
Figure 1.. National and Regional Trends
A, Regional variation in coronavirus disease 2019 (COVID-19) case rates. B, Percentage of waitlist inactivations due to COVID-19. Percentage change in deceased donor recovery (C) and heart transplant volume (D) during the COVID-19 era in the US.
Figure 2.
Figure 2.. National Trends in Waitlist Inactivations and Additions, Deceased Donors Recovered, and Heart Transplants in the US Before and During the Coronavirus Disease 2019 (COVID-19) Pandemic
The blue dashed lines in each panel indicate the transition between the pre–COVID-19 and COVID-19 eras.
See this image and copyright information in PMC

References

    1. DeFilippis EM, Farr MA, Givertz MM. Challenges in heart transplantation in the era of COVID-19. Circulation. Published online April 21, 2020. - PMC - PubMed
    1. Agopian V, Verna E, Goldberg D. Changes in liver transplant center practice in response to COVID-19: Unmasking dramatic center-level variability. Liver Transpl. Published online May 5, 2020. doi:10.1002/lt.25789 - DOI - PMC - PubMed
    1. Loupy A, Aubert O, Reese PP, Bastien O, Bayer F, Jacquelinet C. Organ procurement and transplantation during the COVID-19 pandemic. Lancet. 2020;395(10237):e95-e96. doi:10.1016/S0140-6736(20)31040-0 - DOI - PMC - PubMed
    1. United Network for Organ Sharing COVID-19 and solid organ transplant. Accessed April 23, 2020. https://unos.org/covid/
    1. Hall ME, Vaduganathan M, Khan MS, et al. . Reductions in heart failure hospitalizations during the COVID-19 pandemic. J Card Fail. Published online May, 2020. doi:10.1016/j.cardfail.2020.05.005 - DOI - PMC - PubMed