Managing liver transplantation during the COVID-19 pandemic: A survey among transplant centers in the Southeast United States

doi:10.4254/wjh.v13.i12.2161

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World Journal of Hepatology

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1948-5182

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World J Hepatol. Dec 27, 2021; 13(12): 2161-2167
Published online Dec 27, 2021. doi: 10.4254/wjh.v13.i12.2161

Managing liver transplantation during the COVID-19 pandemic: A survey among transplant centers in the Southeast United States

Adalberto Jose Gonzalez, Nikhil Kapila, Emmanuel Thomas, Antonio Pinna, Andreas Tzakis, Xaralambos Bobby Zervos

Adalberto Jose Gonzalez, Department of Gastroenterology, Cleveland Clinic Florida, Weston, FL 33324, United States

Nikhil Kapila, Antonio Pinna, Andreas Tzakis, Xaralambos Bobby Zervos, Department of Transplant, Cleveland Clinic Florida, Weston, FL 33331, United States

Emmanuel Thomas, Schiff Center for Liver Diseases, University of Miami Miller School of Medicine, Miami, FL 33136, United States

Emmanuel Thomas, Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, United States

Author contributions: Gonzalez AJ and Kapila N wrote the initial manuscript; Thomas E, Pinna A, Tzakis A, and Zervos XB devised the study design and questionnaire and edited the manuscript.

Institutional review board statement: The study did not require approval by the Cleveland Clinic Florida IRB as it was a survey study and did not involve patient data.

Informed consent statement: Informed consent was not needed as no patients were enrolled in this study.

Conflict-of-interest statement: There are no conflicts of interest to report.

Data sharing statement: Data is available upon reasonable request.

STROBE statement: The authors have read the STROBE statement, and the manuscript was prepared and revised according to the STROBE statement checklist of items.

Corresponding author: Xaralambos Bobby Zervos, DO, Doctor, Department of Transplant, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL 33331, United States. zervosx@ccf.org

Received: March 26, 2021
Peer-review started: March 26, 2021
First decision: June 15, 2021
Revised: June 29, 2021
Accepted: October 17, 2021
Article in press: October 17, 2021
Published online: December 27, 2021
Processing time: 275 Days and 16.2 Hours

ARTICLE HIGHLIGHTS

Research background

The coronavirus disease-2019 (COVID-19) pandemic greatly affected liver transplant (LT) centers. This is the first study to investigate the effects of COVID-19 specifically on LT centers and the adjustments made by them to provide care to their patients.

Research motivation

There is limited data on policy adjustments made by LT centers during the pandemic. Our findings can help guide transplant centers during future health care emergencies but also to encourage the development of contingency plans for possible future public health emergencies.

Research objectives

Our main aim was to assess the experience of southeastern United States LT centers during the COVID-19 pandemic. Specifically, we wanted to see how the pandemic affected LT centers and the adjustments made by the centers. We were able to realize these objectives.

Research methods

We performed an observation, survey-based study using a 13-question survey. The survey was sent via electronic mail to 15 LT centers across the Southeastern United States.

Research results

Eleven of fifteen LT centers responded. 100% of centers made adjustments during the COVID-19 pandemic. Greater than 50% of centers performed fewer LTs. 100% of patients were tested for COVID-19, and most centers implemented a virtual platform.

Research conclusions

LT centers varied in their policy adjustments during the COVID-19 pandemic. This was likely due to the lack of clear guidelines. Going forward, the transplant community should use this experience as an important learning opportunity and galvanize contingency plans for possible future public health emergencies.

Research perspectives

Future studies should assess the most effective way to establish and implement clear guidelines to continue liver transplantation during emergency situations. Future studies should also assess which policy adjustments made during the COVID-19 pandemic were safest and most effective in continuing liver transplantation.