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Pausing transplants in the face of a global pandemic: Patient survival implications
The coronavirus disease 2019 (COVID‐19) pandemic has disrupted normal operating procedures at transplant centers. With the possibility that COVID‐19 infection carries an overall 4% mortality rate and potentially a 24% mortality rate among the immunocompromised transplant recipients, many transplant...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9115406/ https://www.ncbi.nlm.nih.gov/pubmed/35601839 http://dx.doi.org/10.1111/poms.13697 |
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author | Zhang, Minmin Wang, Guihua Li, Jun Hopp, Wallace J. Lee, David D. |
author_facet | Zhang, Minmin Wang, Guihua Li, Jun Hopp, Wallace J. Lee, David D. |
author_sort | Zhang, Minmin |
collection | PubMed |
description | The coronavirus disease 2019 (COVID‐19) pandemic has disrupted normal operating procedures at transplant centers. With the possibility that COVID‐19 infection carries an overall 4% mortality rate and potentially a 24% mortality rate among the immunocompromised transplant recipients, many transplant centers considered the possibility of slowing down and even potentially pausing all transplants. Many proposals regarding the need for pausing organ transplants exist; however, much remains unknown. Whereas the impact of the COVID‐19 pandemic on the overall healthcare system is unknown, the potential impact of pausing organ transplants over a period can be estimated. This study presents a model for evaluating the impact of pausing liver transplants over a spectrum of model for end‐stage liver disease‐sodium (MELD‐Na) scores. Our model accounts for two potential risks of a pause: (1) the waitlist mortality of all patients who do not receive liver transplants during the pause period, and (2) the impact of a longer waiting list due to the pause of liver transplants and the continuous accrual of new patients. Using over 12 years of liver transplant data from the United Network for Organ Sharing and a system of differential equations, we estimate the threshold probability above which a decision maker should pause liver transplants to reduce the loss of patient life months. We also compare different pause policies to illustrate the value of patient‐specific and center‐specific approaches. Finally, we analyze how capacity constraints affect the loss of patient life months and the length of the waiting list. The results of this study are useful to decision makers in deciding whether and how to pause organ transplants during a pandemic. The results are also useful to patients (and their care providers) who are waiting for organ transplants. |
format | Online Article Text |
id | pubmed-9115406 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-91154062022-05-18 Pausing transplants in the face of a global pandemic: Patient survival implications Zhang, Minmin Wang, Guihua Li, Jun Hopp, Wallace J. Lee, David D. Prod Oper Manag Special Issue Article The coronavirus disease 2019 (COVID‐19) pandemic has disrupted normal operating procedures at transplant centers. With the possibility that COVID‐19 infection carries an overall 4% mortality rate and potentially a 24% mortality rate among the immunocompromised transplant recipients, many transplant centers considered the possibility of slowing down and even potentially pausing all transplants. Many proposals regarding the need for pausing organ transplants exist; however, much remains unknown. Whereas the impact of the COVID‐19 pandemic on the overall healthcare system is unknown, the potential impact of pausing organ transplants over a period can be estimated. This study presents a model for evaluating the impact of pausing liver transplants over a spectrum of model for end‐stage liver disease‐sodium (MELD‐Na) scores. Our model accounts for two potential risks of a pause: (1) the waitlist mortality of all patients who do not receive liver transplants during the pause period, and (2) the impact of a longer waiting list due to the pause of liver transplants and the continuous accrual of new patients. Using over 12 years of liver transplant data from the United Network for Organ Sharing and a system of differential equations, we estimate the threshold probability above which a decision maker should pause liver transplants to reduce the loss of patient life months. We also compare different pause policies to illustrate the value of patient‐specific and center‐specific approaches. Finally, we analyze how capacity constraints affect the loss of patient life months and the length of the waiting list. The results of this study are useful to decision makers in deciding whether and how to pause organ transplants during a pandemic. The results are also useful to patients (and their care providers) who are waiting for organ transplants. John Wiley and Sons Inc. 2022-03-07 /pmc/articles/PMC9115406/ /pubmed/35601839 http://dx.doi.org/10.1111/poms.13697 Text en © 2022 The Authors. Production and Operations Management published by Wiley Periodicals LLC on behalf of Production and Operations Management Society https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Special Issue Article Zhang, Minmin Wang, Guihua Li, Jun Hopp, Wallace J. Lee, David D. Pausing transplants in the face of a global pandemic: Patient survival implications |
title | Pausing transplants in the face of a global pandemic: Patient survival implications |
title_full | Pausing transplants in the face of a global pandemic: Patient survival implications |
title_fullStr | Pausing transplants in the face of a global pandemic: Patient survival implications |
title_full_unstemmed | Pausing transplants in the face of a global pandemic: Patient survival implications |
title_short | Pausing transplants in the face of a global pandemic: Patient survival implications |
title_sort | pausing transplants in the face of a global pandemic: patient survival implications |
topic | Special Issue Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9115406/ https://www.ncbi.nlm.nih.gov/pubmed/35601839 http://dx.doi.org/10.1111/poms.13697 |
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