Potential regional variations in effects of COVID-19 on federally mandated, program-specific evaluations by the Scientific Registry of Transplant Recipients (SRTR) have been controversial. SRTR January 2022 program evaluations ended transplant follow-up on March 12, 2020, and excluded transplants performed from March 13, 2020 to June 12, 2020 (the “carve-out”). This study examined the carve-out's impact, and the effect of additionally censoring COVID-19 deaths, on first-year posttransplant outcomes for transplants from July 2018 through December 2020. Program-specific hazard ratios (HRs) for graft failure and death estimated under two alternative scenarios were compared with published HRs: (1) the carve-out was removed; (2) the carve-out was retained, but deaths due to COVID-19 were additionally censored. The HRs estimated by censoring COVID-19 deaths were highly correlated with those estimated with the carve-out alone (r² = .96). Removal of the carve-out resulted in greater variation in HRs while remaining highly correlated (r² = .82); however, little geographic impact of the carve-out was observed. The carve-out increased average HR in the Northwest by 0.049; carve-out plus censoring reduced average HR in the Midwest by 0.009. Other regions of the country were not significantly affected. Thus, the current COVID-19 carve-out does not appear to impart substantial bias based on the region of the country.

中文翻译：

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COVID-19 大流行期间的移植计划评估

COVID-19 对移植受者科学登记处 (SRTR) 的联邦授权、特定项目评估的影响的潜在区域差异一直存在争议。SRTR 2022 年 1 月计划评估于 2020 年 3 月 12 日结束了移植随访，并排除了从 2020 年 3 月 13 日至 2020 年 6 月 12 日进行的移植（“排除”）。这项研究检查了 2018 年 7 月至 2020 年 12 月期间例外情况的影响，以及额外审查 COVID-19 死亡对第一年移植后结果的影响。移植失败和死亡的特定项目风险比 (HR) 估计如下将两种替代方案与已发布的 HR 进行了比较：(1) 剥离被删除；(2) 保留例外情况，但额外审查了因 COVID-19 造成的死亡。r ²  = .96）。去除分拆导致 HR 的变化更大，同时保持高度相关 ( r ²  = .82)；然而，几乎没有观察到分拆的地理影响。剥离使西北地区的平均人力资源增加了 0.049；分拆加审查使中西部的平均人力资源减少了 0.009。该国其他地区没有受到重大影响。因此，当前的 COVID-19 分拆似乎不会根据该国的地区产生重大偏见。