Table 1.

Application of Haddon matrix to organ transplantation during COVID‐19 pandemic

Epidemiologic dimensions
Event dimensions	Host factors	Agent	Environment
			Physical	Sociocultural
Pre‐transplantation	Minimize organ contamination and shipping Minimize recipient travel Provider training in infection control Individualized donor selection to minimize anticipated DGF necessitating post‐transplant dialysis Recipient selection to minimize anticipated DGF SAR‐CoV‐2 screening in donors and recipients	Contagiousness of COVID‐19 viruses Virulence of COVID‐19 viruses	Infection control infrastructure Availability of donor and recipient COVID‐19 testing Availability of PPE Plan for increased capacity for COVID‐19 cases	Societal attitudes toward COVID‐19 Provider adherence to infection control policies Resource allocation and prioritization
Transplantation	Underlying co‐morbidities Healthcare providers’ practice Risk communication to patient and staff	Mode of COVID‐19 transmission during	Capacity to quarantine if indicated Designated area for COVID‐19 cases Medical equipment and potential effective anti‐viral therapies	Practical and ethical considerations for organ transplantation Budgets for resource utilization Patients and family adherence to infection control policy Appropriate communication about COVID‐19 to patients
Post‐transplantation	Post‐infection management and surveillance	Persistent COVID‐19 in the environment COVID‐19 virus mutation Research pertaining to treatment, immunization	Post‐infection decontamination Patient transportation availability	Psychological support Financial support for transplant centers and hospitals affected by COVID‐19 Support for patients and their communities affected by COVID‐19

Abbreviations: COVID‐19, coronavirus disease 2019; DGF, delayed graft function, PPE, personal protective equipment, SARS‐CoV‐2, severe acute respiratory syndrome coronavirus 2.