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. 2022 Nov 6;11(21):6581.
doi: 10.3390/jcm11216581.

Impact of the COVID-19 Pandemic on Solid Organ Transplant and Rejection Episodes in Brazil's Unified Healthcare System

Luis Gustavo Modelli de Andrade  1 , Abner Macola Pacheco Barbosa  1 , Naila Camila da Rocha  1 , Marilia Mastrocolla de Almeida Cardoso  2 , Juliana Tereza Coneglian de Almeida  2 , Juliana Machado-Rugolo  2 , Lucas Frederico Arantes  2 , Daniela Ferreira Salomão Pontes  1 , Gustavo Fernandes Ferreira  3
Affiliations

Impact of the COVID-19 Pandemic on Solid Organ Transplant and Rejection Episodes in Brazil's Unified Healthcare System

Luis Gustavo Modelli de Andrade et al. J Clin Med. .

Abstract

Background: Brazil has the world's largest public organ transplant program, which was severely affected by the COVID-19 pandemic. The primary aim of the study was to evaluate differences in solid organ transplants and rejection episodes during the COVID-19 pandemic compared to the five years before the pandemic in the country.

Methods: A seven-year database was built by downloading data from the DATASUS server. The pandemic period was defined as March 2020 to December 2021. The pre-pandemic period was from January 2015 to March 2020.

Results: During the pandemic, the number of solid organ transplants decreased by 19.3% in 2020 and 22.6% in 2021 compared to 2019. We found a decrease for each evaluated organ, which was more pronounced for lung, pancreas, and kidney transplants. The seasonal plot of rejection data indicated a high rejection rate between 2018 and 2021. There was also an 18% (IRR 1.18 (95% CI 1.01 to 1.37), p = 0.04) increase in the rejection rate during the COVID-19 pandemic.

Conclusions: The total number of organ transplants performed in 2021 represents a setback of six years. Transplant procedures were concentrated in the Southeast region of the country, and a higher proportion of rejections occurred during the pandemic. Together, these findings could have an impact on transplant procedures and outcomes in Brazil.

Keywords: Brazil; COVID-19; graft rejection; organ transplant.

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Conflict of interest statement

We declare no conflict of interests.

Figures

Figure 1
Figure 1
Total number of solid organ transplants performed in Brazil’s Unified Healthcare System (SUS) from 2015 to 2021. (A) All solid organ transplants; (B) individual graphs for each type of solid organ transplant. #: number.
Figure 2
Figure 2
Total number of solid organ transplants performed in Brazil’s Unified Healthcare System (SUS) from 2015 to 2021 by state.
Figure 3
Figure 3
Total rejection episodes corrected for the number of transplants performed in Brazil’s Unified Healthcare System (SUS). (A) Monthly data plot divided into pre-pandemic (January 2015 to March 2020) and COVID-19 pandemic (March 2020 to December 2021) periods. (B) Normalized plot (difference from the median) per year from January 2015 to December 2021. #: number.
See this image and copyright information in PMC

References

    1. Cristelli M.P., Ferreira G.F., Medina-Pestana J. Global Perspective on Kidney Transplantation: Brazil. Kidney360. 2021;2:2016–2018. doi: 10.34067/KID.0003612021. - DOI - PMC - PubMed
    1. DATASUS—Ministério Da Saúde. [(accessed on 21 July 2022)]; Available online: https://datasus.saude.gov.br/
    1. Saldanha R.d.F., Bastos R.R., Barcellos C. Microdatasus: A package for downloading and preprocessing microdata from Brazilian Health Informatics Department (DATASUS) Cad. Saude Publica. 2019;35:e00032419. doi: 10.1590/0102-311x00032419. - DOI - PubMed
    1. Ribeiro Junior M.A.F., Costa C.T.K., Néder P.R., Aveiro I.D.A., Elias Y.G.B., Augusto S.D.S. Impact of COVID-19 on the Number of Transplants Performed in Brazil during the Pandemic. Current Situation. Rev. Col. Bras. Cir. 2021;48:e20213042. doi: 10.1590/0100-6991e-20213042. - DOI - PMC - PubMed
    1. Requião-Moura L.R., Sandes-Freitas T.V., Viana L.A., Cristelli M.P., Andrade L.G.M., Garcia V.D., Oliveira C.M.C., Esmeraldo R.M., Abbud Filho M., Pacheco-Silva A., et al. High Mortality among Kidney Transplant Recipients Diagnosed with Coronavirus Disease 2019: Results from the Brazilian Multicenter Cohort Study. PLoS ONE. 2021;16:e0254822. doi: 10.1371/journal.pone.0254822. - DOI - PMC - PubMed

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