Solid organ transplantation during COVID-19 pandemic: an international web-based survey on resources’ allocation

COVID-19 and Solid Organ Transplant Study Group, Francesco Giovinazzo, Alfonso Avolio*, Federica Galiandro, Alessandro Vitale, Giulio V, Dalla Riva, Gianni Biancofiore, Shivani Sharma, Paolo Muiesan, Salvatore Agnes, Patrizia Burra

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Solid Organ Transplants (SOTs) are life-saving interventions, recently challenged by coronavirus disease 2019
(COVID-19). SOTs require a multistep process, which can be affected by COVID-19 at several phases.
SOT-specialists, COVID-19-specialists, and medical ethicists designed an international survey according to
CHERRIES guidelines. Personal opinions about continuing SOTs, safe managing of donors and recipients, as
well as equity of resources’ allocation were investigated. The survey was sent by e-mail. Multiple approaches
were used (corresponding authors from Scopus, websites of scientific societies, COVID-19 webinars). After
the descriptive analysis, univariate and multivariate ordinal regression analysis was performed.
There were 1819 complete answers from 71 countries. The response rate was 49%. Data were stratified
according to region, macro-specialty, and organ of interest. Answers were analyzed using univariate-multivariate
ordinal regression analysis and thematic analysis. Overall, 20% of the responders thought SOTs should not stop
(continue transplant without restriction); over 70% suggested SOTs should selectively stop, and almost 10%
indicated they should completely stop. Furthermore, 82% agreed to shift resources from transplant to COVID-19
temporarily. Briefly, main reason for not stopping was that if the transplant will not proceed the organ will be
wasted. Focusing on SOT from living donors, 61% stated that activity should be restricted only to “urgent” cases.
At the multivariate analysis, factors identified in favour of continuing transplant were: Italy, ethicist,
partially disagreeing on the equity question, a high number of COVID-19 related deaths on the day of the answer,
a high IHDI country. Factors predicting to stop SOTs were: Europe except-Italy, public university hospital, and
strongly agreeing on the equity question.
In conclusion, the majority of responders suggested that transplant activity should by continued
through the implementation of isolation measures and the adoption of the COVID-19 free pathways.
Differences, between professional categories are less strong than supposed.
Original languageEnglish
Article numbere669
Number of pages16
JournalTransplantation Direct
Issue number3
Publication statusPublished - 11 Feb 2021


Dive into the research topics of 'Solid organ transplantation during COVID-19 pandemic: an international web-based survey on resources’ allocation'. Together they form a unique fingerprint.

Cite this