Geographic Differences in Lung Transplant Volume and Donor Availability During the COVID-19 Pandemic

Benvenuto, Luke; Snyder, Mark E.; Aversa, Meghan; Patel, Shreena; Costa, Joseph; Shah, Lori; Robbins, Hilary; D’Ovidio, Frank; Sonett, Joshua; Stanifer, Bryan P.; Lemaitre, Philippe; Arcasoy, Selim; Anderson, Michaela R.

BACKGROUND. Regional variation in lung transplantation practices due to local coronavirus disease 2019 (COVID-19) prevalence may cause geographic disparities in access to lung transplantation. METHODS. Using the United Network for Organ Sharing registry, we conducted a descriptive analysis of lung transplant volume, donor lung volume, new waitlist activations, and waiting list deaths at high-volume lung transplant centers during the first 3 months of the pandemic (March 1. 2020, to May 30, 2020) and we compared it to the same period in the preceding 5 years. RESULTS. Lung transplant volume decreased by 10% nationally and by a median of 50% in high COVID-19 prevalence centers (range –87% to 80%) compared with a median increase of 10% (range –87% to 80%) in low prevalence centers (P-for-trend 0.006). Donation services areas with high COVID-19 prevalence experienced a greater decrease in organ availability (-28% range, –72% to –11%) compared with low prevalence areas (+7%, range –20% to + 55%, P-for-trend 0.001). Waiting list activations decreased at 18 of 22 centers. Waiting list deaths were similar to the preceding 5 years and independent of local COVID-19 prevalence (P-for-trend 0.36). CONCLUSIONS. Regional variation in transplantation and donor availability in the early months of the pandemic varied by local COVID-19 activity.