During the first wave of the COVID-19 pandemic in March-April 2020, kidney waitlist registrations and kidney transplantations plummeted in the United States, followed by encouraging recovery, investigators reported at the virtual American Transplant Congress 2021.

Allan B. Massie, PhD, and collaborators from Johns Hopkins University in Baltimore, Maryland, compared expected with actual rates of transplant services from March to October 2020 using data from The Scientific Registry of Transplant Recipients. Kidney waitlisting dropped from 19% below normal in March to 45% below normal in May, then showed steady recovery through October, when new listings were only 6% below normal, the investigators reported. Waitlist deaths peaked at 72% above expected in March-April, declined to 7% above expected in June, then climbed again to 16% above expected in August, during a second wave of COVID-19 infection.

Deceased donor kidney transplantations were 25% below normal in March, increased to 11% above normal in July, then dipped to 5% above normal in October. Living donor kidney transplants bottomed out at 87% below expected in March-April, peaked at 10% below expected in July and then dipped to 14% below expected in both September and October.

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“Each successive wave had a lesser impact on transplant and waitlist mortality rates,” Dr Massie’s team wrote. “New listings have approached pre-pandemic rates, suggesting that the medical system has successfully adapted to the challenges of COVID-19, despite occasionally high patient load caused by additional epidemic waves.”


Bisen S, Boyarsky B, Werbel W, et al. Response to a pandemic: The fall and rise of kidney transplantation in the US. Am J Transplant. 2021;21(suppl 3). Presented at the virtual American Transplant Congress, June 5-9, 2021. Abstract 426.