INTRODUCTION:
Heart transplantation remains the definitive therapy for patients who
suffer from end-stage heart failure. Since it was first performed in
1967, the number of patients who have benefited from this therapy has
continued to increase1,2. The past two decades have
seen the introduction of new, improved immunosuppression which has
allowed for longer allograft survival and innovations in donor recovery.
The organ donor pool has been expanded by the utilization of hepatitis C
donors and ex vivo perfusion platforms3. These
developments hold promise for the meaningful increase in the number of
adult heart transplants performed in the United States.
The spring of 2020 saw the widespread recognition of a novel coronavirus
(COVID-19) which has had a global impact. In the United States, the
affect has been wide ranging. Nowhere has this been more apparent than
the healthcare landscape. An increase in demand for hospital beds for
COVID-19 positive patients coupled with hospital-driven initiatives to
reduce non-emergent treatments has resulted in a nation-wide reduction
in operative volume4. Moreover, patient concerns
regarding infection with COVID-19 has resulted in many patients
deferring medical care for both major and minor
concerns5. At its worst, we witnessed reduction in
case volume between 20-90% compared to last year across all service
lines at our hospital.
The impact of COVID-19 on the availability of donor organs and the
impact on solid organ transplant remains unclear. Here we examine the
impact of COVID-19 on a single, large-volume heart transplant program.