Opinion Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Oct 18, 2020; 10(10): 277-282
Published online Oct 18, 2020. doi: 10.5500/wjt.v10.i10.277
COVID-19 pandemic: Building organisational flexibility to scale transplant programs
Jeevan Prakash Gopal, Vassilios E Papalois
Jeevan Prakash Gopal, Imperial College Renal and Transplant Center, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London W12 0HS, United Kingdom
Vassilios E Papalois, Imperial College Renal and Transplant Center, Department of Surgery and Cancer, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London W12 0HS, United Kingdom
Author contributions: Gopal JP performed the literature search and wrote the manuscript; Papalois VE identified key areas to be addressed, made critical corrections to the manuscript and approved the final version.
Conflict-of-interest statement: The authors declare that they have no competing or conflicts of interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jeevan Prakash Gopal, MBBS, Surgeon, Imperial College Renal and Transplant Center, Hammersmith Hospital, Imperial College Healthcare NHS Trust, Du Cane Road, London W12 0HS, United Kingdom. jeevan.gopal@nhs.net
Received: July 11, 2020
Peer-review started: July 11, 2020
First decision: July 25, 2020
Revised: August 4, 2020
Accepted: August 31, 2020
Article in press: August 31, 2020
Published online: October 18, 2020
Processing time: 96 Days and 11.9 Hours
Abstract

The prevailing coronavirus disease 2019 pandemic has challenged our lives in an unprecedented manner. The pandemic has had a significant impact on transplantation worldwide. The logistics of travel restrictions, stretching of available resources, unclear risk of infection in immunosuppressed transplant recipients, and evolving guidelines on testing and transplantation are some of the factors that have unfavourably influenced transplant activity. We must begin to build organisational flexibility in order to restart transplantation so that we can be mindful stewards of organ donation and sincere advocates for our patients. Building a culture of honesty and transparency (with patients, families, colleagues, societies, and authorities), keeping the channels of communication open, working in collaboration with others (at local, regional, national, and international levels), and not restarting without rethinking and appraising all elements of our practice, are the main underlying principles to increase the flexibility.

Keywords: Organisational flexibility; Clinical decision making; COVID-19; Organ donation; Care delivery; Transplantation

Core Tip: We have described our views and the underlying principles regarding building a flexible organisation to optimize the ability to efficiently handle a pandemic. As we are significantly advanced through the pandemic, the desire to go back to routine is gaining momentum, and as most of the programs around the globe are planning to safely restart or expand their activity, it is crucial for any organisation to be flexible in order to maintain sustainability.