Changes in the liver transplant evaluation process during the early COVID-19 era and the role of telehealth.

Abstract

Coronavirus disease 2019 (COVID-19) disrupted healthcare and led to increased telehealth use. We explored the impact of COVID-19 on liver transplant evaluation (LTE).To understand the impact of telehealth on LTE during COVID-19 and to identify disparities in outcomes disaggregated by sociodemographic factors.This was a retrospective study of patients who initiated LTE at our center from 3/16/20-3/16/21 ("COVID-19 era") and the year prior (3/16/19-3/15/20, "pre-COVID-19 era"). We compared LTE duration times between eras and explored the effects of telehealth and inpatient evaluations on LTE duration, listing, and pre-transplant mortality.One hundred and seventy-eight patients were included in the pre-COVID-19 era cohort and one hundred and ninety-nine in the COVID-19 era cohort. Twenty-nine percent (58/199) of COVID-19 era initial LTE were telehealth, compared to 0% (0/178) pre-COVID-19. There were more inpatient evaluations during COVID-19 era (40% vs 28%, P < 0.01). Among outpatient encounters, telehealth use for initial LTE during COVID-19 era did not impact likelihood of listing, pre-transplant mortality, or time to LTE and listing. Median times to LTE and listing during COVID-19 were shorter than pre-COVID-19, driven by increased inpatient evaluations. Sociodemographic factors were not predictive of telehealth.COVID-19 demonstrates a shift to telehealth and inpatient LTE. Telehealth does not impact LTE or listing duration, likelihood of listing, or mortality, suggesting telehealth may facilitate LTE without negative outcomes.

View details for DOI 10.5500/wjt.v15.i2.99401

View details for PubMedID 40535485

View details for PubMedCentralID PMC11886291