RESULTS:
The first confirmed case of COVID-19 in the state of Tennessee was on
March 5, 2020. By June 30, 2020, the total number of confirmed cases in
the state was 43,806. Over this same period of time, our total cardiac
volume was 488 cases compare to 521 cases during March-June 2019. The
most significant decrease in volume was seen in April 2020 where volume
was reduced by nearly 30% compared to the previous year.
From March-June 2020, 43 total orthotopic heart transplants were
performed. This includes three re-transplants and seven multi-organ
transplants (6 heart/kidney; 1 heart/liver; 0 heart/lung). The average
recipient age was 54.2 +/- 13.9 years and 29 recipients were male and 14
were female. Thirty recipients were Caucasian. Thirteen recipients were
African American. There were 11 blood type A recipients, seven blood
type B recipients, one blood type AB recipient and 24 blood type O
recipients. Sixteen patients had pre-operative durable left ventricular
assist devices (LVAD). The average listing status at time of transplant
was 3.3 +/- 1.4. The average time on the wait list was 147.44 +/- 195.85
days.
From March-June 2019, 31 total orthotopic heart transplants were
performed. This includes three re-transplants and three multi-organ
transplants (3 heart/kidney; 0 heart/liver; 0 heart/lung). The average
recipient age was 47.5 +/- 13.3 years and 18 recipients were male and 13
were female. Twenty-three patients were Caucasian. Eight patients were
African American. One patient was Asian-American. There were 15 blood
type A recipients, five blood type B recipients, one blood type AB
recipient and 10 blood type O recipients. Eight patients had
pre-operative durable left ventricular assist devices (LVAD). The
average listing status at time of transplant was 3.0 +/-.99. The average
time on the wait list was 112.94 +/- 260.11 days. There was no
significant difference in recipient demographic variables across groups
except for race of the transplant recipients (p= 0.029) (TABLE 1).
Donor variables over these two time periods were not different (TABLE
2). From March-June 2020, the average donor age was 29.1 +/- 8.3 years
and 30 donors were male and 13 were female. Thirty-one donors were
Caucasian. Seven donors were African American. One donor was Hispanic.
One donor was Native American. Ten donors were hepatitis C positive.
Twenty donors were characterized as high risk. The average time of
allograft travel to the recipient hospital was 88.49 +/- 53.5 minutes.
From March-June 2019, the average donor age was 32.0 +/- 8.8 years and
18 donors were male and 13 were female. Twenty-six donors were
Caucasian. Three donors were African American. Two donors were Hispanic.
Fifteen donors were hepatitis C positive. Seventeen donors were
characterized as high risk. The average time of allograft travel to the
recipient hospital was 87.87 +/- 36.05 minutes. In addition, there was
no difference in the number of local versus imported organs over these
two periods of time.
Of the 43 transplants performed between March-June 2020, 41 achieved
30-day survival. Four recipients needed post-operative continuous renal
replacement therapy. The average total length of stay was 18.2 +/- 8.1
days and the average intensive care unit length of stay was 6.1 +/- 3.1
days. Four patients had primary graft dysfunction and six patients had
rejection (2R or greater) at 30 days6.
Of the 31 transplants performed between March-June 2019, 30 achieved
30-day survival. Nine patients needed post-operative continuous renal
replacement therapy. The average total length of stay was 23.0 +/- 13.4
days and the average intensive care unit length of stay was 11.0 +/- 8.7
days. Three patients had primary graft dysfunction and three patients
had rejection (2R or greater) at 30 days. The only significant
difference in recipient outcome was the incidence of continuous renal
replacement therapy (p= 0.01) (Table 3).
There was no evidence of acute, post-operative infection of any
recipient with COVID-19 during this time period.