Table 2.
Results of the questionnaire on the status of transplant programs
| Answer | Overall (%) n = 177 |
Heart n = 11 |
Lung n = 9 |
Liver n = 25 |
Kidney n = 103 |
Pancreas n = 18 |
Small intestine n = 11 |
||
|---|---|---|---|---|---|---|---|---|---|
| Q10 | Have you ever discussed the continuation of the transplant surgeries in the hospital during the COVID-19 pandemic? | Yes | 151 (85) | 8 (73) | 6 (67) | 20 (80) | 94 (91) | 15 (83) | 8 (73) |
| No | 26 (15) | 3 (27) | 3 (33) | 5 (20) | 9 (9) | 3 (17) | 3 (27) | ||
| Q11 | To what extent did that discussion take place? | Single department | 41 (23) | 0 (0) | 1 (17) | 5 (25) | 30 (32) | 3 (20) | 2 (25) |
| Multiple department | 57 (32) | 5 (63) | 0 (0) | 9 (45) | 31 (33) | 8 (53) | 4 (50) | ||
| All over hospital | 44 (25) | 3 (38) | 5 (83) | 5 (25) | 25 (27) | 4 (27) | 2 (25) | ||
| Others | 7 (4) | 0 (0) | 0 (0) | 1 (5) | 6 (6) | 0 (0) | 0 (0) | ||
| Q12 | Have the organ transplant surgeries in your hospital been stopped due to the COVID-19 pandemic? | Yes | 85 (48) | 0 (0) | 0 (0) | 1 (4) | 80 (78) | 4 (22) | 0 (0) |
| No | 92 (52) | 11 (100) | 9 (100) | 24 (96) | 23 (22) | 14 (78) | 11 (100) | ||
| Q13 | What was the reason for the decision to suspend the organ transplant surgeries? (Multiple answers allowed) | Presence of COVID-19-positive patients after transplantation in the hospital | 0 (0) | N/A | N/A | 0 (0) | 0 (0) | 0 (0) | N/A |
| Presence of COVID-19-positive patients in the hospital | 12 (7) | N/A | N/A | 1 (100) | 11 (14) | 0 (0) | N/A | ||
| Presence of COVID-19-positive patients in the area (prefecture) | 26 (15) | N/A | N/A | 0 (0) | 26 (33) | 0 (0) | N/A | ||
| In-hospital medical care system or examination system inadequate for assessing COVID-19 | 34 (19) | N/A | N/A | 1 (100) | 33 (41) | 0 (0) | N/A | ||
| All surgical treatments restricted, including transplantation | 33 (19) | N/A | N/A | 1 (100) | 30 (38) | 2 (50) | N/A | ||
| Following the guidelines of the Japan Society for Transplantation | 57 (32) | N/A | N/A | 0 (0) | 54 (68) | 3 (75) | N/A | ||
| Others | 16 (9) | N/A | N/A | 0 (0) | 15 (19) | 1 (25) | N/A | ||
| Q14 | What kind of organ transplants were suspended? | Both deceased donor transplants and living donor transplantation | 56 (31) | N/A | N/A | 1 (100) | 51 (64) | 4 (100) | N/A |
| Only living donor transplantation | 25 (14) | N/A | N/A | 0 (0) | 25 (31) | 0 (0) | N/A | ||
| Only high-risk transplantation including ABO incompatible cases | 0 (0) | N/A | N/A | 0 (0) | 0 (0) | 0 (0) | N/A | ||
| Deceased donor transplantation | 1 (1) | N/A | N/A | 0 (0) | 1 (1) | 0 (0) | N/A | ||
| Others | 3 (2) | N/A | N/A | 0 (0) | 3 (4) | 0 (0) | N/A | ||
| Q15 | What was the reason for resuming the organ transplant surgeries? (Multiple answers allowed) | Reduction in numbers of COVID-19 infections in the hospital | 9 (5) | N/A | N/A | 0 (0) | 8 (11) | 1 (25) | N/A |
| A lack of spread of COVID-19 infection confirmed in the hospital | 11 (6) | N/A | N/A | 1 (100) | 8 (11) | 2 (50) | N/A | ||
| Reduction in numbers of COVID-19 infections in the local area | 29 (16) | N/A | N/A | 0 (0) | 27 (36) | 2 (50) | N/A | ||
| Establishment of an in-hospital medical care system and examination system for COVID-19 | 51 (29) | N/A | N/A | 1 (100) | 48 (64) | 2 (50) | N/A | ||
| Restrictions on surgeries other than transplantation lifted | 28 (16) | N/A | N/A | 1 (100) | 25 (33) | 2 (50) | N/A | ||
| Following the guidelines of the Japan Society for Transplantation | 34 (19) | N/A | N/A | 0 (0) | 32 (43) | 2 (50) | N/A | ||
| Others | 8 (4) | N/A | N/A | 0 (0) | 8 (11) | 0 (0) | N/A | ||
| Q16 | What kind of organ transplants are being performed if the program is ongoing? | Without any particular restrictions | 112 (63) | 11 (100) | 6 (67) | 14 (56) | 66 (69) | 9 (50) | 6 (55) |
| Limited to cases considering being difficult to postpone | 34 (19) | 0 (0) | 1 (11) | 9 (36) | 15 (16) | 5 (28) | 4 (36) | ||
| Others | 18 (10) | 0 (0) | 1 (11) | 2 (8) | 10 (10) | 4 (22) | 1 (9) | ||
| Q17 | If the COVID-19 epidemic expands more in the near future, how do you think that organ transplants be carried out in your hospital? | Without any particular restrictions | 30 (17) | 5 (45) | 1 (11) | 4 (16) | 13 (14) | 4 (22) | 3 (27) |
| Considering discontinuing their transplant surgeries depending on the presence of COVID-19 patients in the ICU | 60 (34) | 5 (45) | 7 (78) | 15 (60) | 20 (21) | 6 (33) | 7 (64) | ||
| Considering discontinuing their transplant surgeries depending on the presence of COVID-19 patients in the hospital | 32 (18) | 1 (9) | 0 (0) | 6 (24) | 19 (20) | 3 (17) | 3 (27) | ||
| Discontinue the transplant surgeries should nosocomial COVID-19 infection be observed | 34 (19) | 1 (9) | 0 (0) | 2 (8) | 30 (31) | 0 (0) | 1 (9) | ||
| Not decided, yet | 24 (13) | 2 (18) | 1 (11) | 2 (8) | 15 (16) | 4 (22) | 0 (0) | ||
| Others | 23 (13) | 0 (0) | 0 (0) | 3 (12) | 16 (17) | 4 (22) | 0 (0) | ||
| Q18 | Have you placed any restrictions on the dispatch of organ recovery from your center during the COVID-19 pandemic? | Yes | 21 (12) | 0 (0) | 0 (0) | 1 (4) | 18 (17) | 1 (6) | 1 (9) |
| No | 148 | 11 (100) | 9 (100) | 22 (88) | 79 (77) | 17 (94) | 10 (91) | ||
| Q19 | Have you experienced any cases in which organ recovery was abandoned due to a COVID-19 infection? | Yes | 14 (8) | 3 (27) | 0 (0) | 0 (0) | 8 (8) | 3 (17) | 0 (0) |
| No | 156 (88) | 8 (73) | 9 (100) | 23 (92) | 90 (87) | 15 (83) | 11 (100) | ||
| Q20 | Have you experienced any cases in which organ transplantation was abandoned due to a COVID-19 infection even though organ recovery was possible? | Yes | 12 (7) | 1 (9) | 1 (11) | 0 (0) | 9 (9) | 1 (6) | 0 (0) |
| No | 158 (89) | 10 (91) | 8 (89) | 23 (92) | 89 (86) | 17 (94) | 11 (100) | ||
| Q21 | How do you handle patients who are candidates for organ transplantation during the COVID-19 pandemic? (Multiple answers allowed) | Be sure to perform chest CT | 125 (70) | 8 (73) | 6 (67) | 11 (44) | 85 (83) | 13 (72) | 2 (18) |
| Perform chest CT if the patient has some symptoms | 16 (9) | 1 (9) | 0 (0) | 5 (20) | 3 (3) | 3 (17) | 4 (36) | ||
| Be sure to screen for COVID-19 (PCR test, antigen test, etc.) | 161 (90) | 9 (82) | 9 (100) | 22 (88) | 93 (90) | 18 (100) | 10 (91) | ||
| Screen for COVID-19 (PCR test, antigen test, etc.), if there are chest CT findings or the patient has some symptoms | 6 (3) | 1 (9) | 0 (0) | 2 (8) | 2 (2) | 0 (0) | 1 (9) | ||
| Others | 6 (3) | 1 (9) | 0 (0) | 0 (0) | 5 (5) | 0 (0) | 0 (0) | ||
| Q22 | Have there been any changes in the post-transplant follow-up systems during the COVID-19 pandemic in your hospital? | No change | 65 (37) | 6 (55) | 3 (33) | 9 (36) | 37 (36) | 6 (33) | 4 (36) |
| The system has changed a little | 80 (45) | 5 (45) | 6 (67) | 11 (44) | 45 (44) | 9 (50) | 4 (36) | ||
| The system has changed considerably | 29 (16) | 0 (0) | 0 (0) | 5 (20) | 18 (17) | 3 (17) | 3 (27) | ||
| The system has all changed | 3 (2) | 0 (0) | 0 (0) | 0 (0) | 3 (3) | 0 (0) | 0 (0) | ||
| Q23 | If you answered "yes" to Q22, please explain how the post-transplant follow-up systems have changed. (Multiple answers allowed) | Outpatient visits for patients after transplantation were set to be performed at longer intervals | 123 (69) | 6 (100) | 4 (80) | 16 (76) | 77 (94) | 12 (92) | 8 (89) |
| Try to give more medicine than usual | 66 (37) | 4 (67) | 3 (60) | 9 (43) | 44 (54) | 4 (31) | 2 (22) | ||
| Examination are limited as much as possible | 14 (8) | 0 (0) | 1 (20) | 2 (10) | 9 (11) | 2 (15) | 0 (0) | ||
| Try to patients stay in the out-patients clinic as short as possible | 51 (29) | 2 (33) | 3 (60) | 5 (24) | 35 (43) | 4 (31) | 2 (22) | ||
| Try to make each other patients avoid contact | 36 (20) | 3 (50) | 2 (40) | 5 (24) | 21 (26) | 2 (15) | 3 (33) | ||
| Others | 21 (12) | 2 (33) | 3 (60) | 5 (24) | 8 (10) | 1 (8) | 2 (22) |