Global and Country-Level Impact of COVID-19 on Heart Transplant Volumes

PURPOSE: Shifting healthcare resources to deal with the COVID-19 has hampered heart transplant programs around the world, making orthotopic heart transplant (OHT) less feasible. We aim to describe the global impact of COVID-19 on OHT volumes one year after the pandemic. METHODS: Using data from the Global Observatory on Donation and Transplantation (GODT), the world's most comprehensive source of data on organ donation and transplantation, we determined the number of OHT procedures performed in the years 2019 (pre-COVID-19 era) and 2020 (COVID-19 era). Countries with reported data on OHT volumes in both years (n=51 countries) were included. OHT volumes were reported for each country per million population (PMP), and change in the COVID-19 era was expressed as a percentage of the pre-COVID-19 rates of OHT PMP. RESULTS: Among countries included in this analysis, the number of OHT decreased by 9.3% during the COVID-19 era (a decrease from 1.82 to 1.65 OHT PMP). However, significant variability existed among included countries, such that 76.5% (39/51) of countries experienced a reduction in OHT volumes during the COVID-19 era (median OHT of 2.56 PMP in 2019 vs. 1.84 in 2020, median difference -0.53 OHT PMP, IQR [-0.83, -0.2], p<0.001) while the rest experienced an increase in OHT volumes (median OHT of 4.1 PMP in 2019 vs. 5 in 2020, median difference 0.47 OHT PMP, IQR [0.12, 0.95], p=0.002). Figure.1 features changes in OHT volumes after COVID-19 around the world. CONCLUSION: In a representative sample of countries around the world, OHT volumes decreased significantly during the early phase of COVID-19 pandemic in most, but not all countries around the world. Understanding the causes leading to heterogeneity in change in OHT volumes during COVID-19 pandemic may help uncover essential strategies to maintain organ transplantation activities during similar circumstances in the future.