Outcome of patients waitlisted for Deceased Donor Liver transplantation during COVID-19 pandemic - A Single centre experience.

BACKGROUND AND AIM: COVID-19 pandemic has strained several healthcare resources across the world. While Liver transplantation (LT) is the only curative therapy for patients with end stage liver disease, we aimed to determine the clinical outcome of patients waitlisted for DDLT during COVID-19 pandemic.

METHODS: A retrospective comparative observational study of adult patients waitlisted for DDLT from January 2019 to January 2022 at our liver unit (Dr Rela Institute and Medical Center, Chennai, Tamil Nadu, India) was carried out. Patient demographics, disease etiology, MELD Na (Model for end stage liver disease sodium) score were calculated for all patients listed during the study period. Clinical event was defined as number of DDLT, death in the absence of transplant and patients awaiting liver transplantation were compared. Statistical analysis was performed with SPSS V24.0.

RESULTS: 310 patients were waitlisted for DDLT, of whom 148, 63 and 99 patients listed during 2019, 2020 and 2021 (till January 2022), respectively. 22 (53.6%), 10 (24.3%) and 9 (21.9%) patients underwent DDLT in the year 2019, 2020 and 2021 (P=0.000). 137 patients (44.19%) died on the DDLT waitlist of whom 41 (29.9%), 67 (48.9%) and 29 (21.1%) in the year 2019, 2020 and 2021 (P=0.000), respectively. Waitlist mortality was significantly higher during the COVID first wave.

CONCLUSION: COVID-19 pandemic has significantly impacted patients waitlisted for DDLT in India. With limited access to healthcare facilities and decreased organ donation rates during the pandemic, there was a considerable reduction in the patients waitlisted for DDLT, lesser number of patients underwent DDLT, higher waitlist mortality during the pandemic year. Efforts to improve organ donation in India should be strongly implemented.