Effects on the Patient Pathway for Heart and Lung Transplantation During the COVID 19 Pandemic

Abstract

To evaluate the impact of Coronavirus on the cardiopulmonary transplant program we compared mortality during the pandemic with each of the previous 5 years activity with reference to the stages of the patient pathway from referral, through assessment, waiting list and post transplantation. The deaths had been retrospectively reviewed throughout the entire cardiothoracic transplant pathway between 2015 and December 2019. The patients have been categorized into pre- and post-transplant cohorts. Pre-transplant patients were further subdivided depending upon their stage in the assessment process–referral, assessment, or active waiting list. Prospectively the deaths in the pathway have been analyzed during the Coronavirus pandemic from January 2020 to June 2021 and compared deaths at each stage in the pathway to determine the impact on this vulnerable group. Surprisingly the retrospective review did not suggest any rise in mortality in this vulnerable population due to COVID. Most patients, being aware of the risks and effects of COVID on their disease, may have exercised extreme caution, effectively isolated, and shielded from contacts and strictly followed a personal hygiene policy. This may well explain the effectiveness of these measures in protecting this population. There is evidence that vaccination may have limited efficacy in transplant recipients and so the effectiveness of shielding and hygiene can be shown to have a demonstrable protective impact on this vulnerable group.