Key result
COVID-19 pandemic linked to a sustained ~52% drop in transplant volumes despite overall cardiothoracic recovery.
Why the study?
Following significant disruptions to cardiothoracic surgery and transplant services during the COVID-19 pandemic, this study assessed persistent impacts and recovery patterns five years post-onset.
Observational (n=2,980)
No
Absolute Event Rate: 494% vs 510%
While general cardiothoracic surgery volumes in Ireland largely recovered to pre-pandemic levels by 2025, heart and lung transplant volumes remain persistently suppressed, highlighting the need for targeted interventions to address transplant service backlogs.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“These findings are deeply worrying but unfortunately not surprising. Behind every statistic is a person and a family living with the reality of a life-limiting lung disease. For many people with lung fibrosis, a transplant is their only chance of survival. When transplant numbers remain persistently low, patients pay the price.”
Persistent transplant volume halving signals ongoing system strain; leaves open whether targeted interventions can restore pre-pandemic levels.
Background The COVID-19 pandemic caused significant disruptions to cardiothoracic surgery and transplant services globally, with our initial 2020 study reporting a 50% reduction in activity during March–April 2020. This follow-up assesses persistent impacts and recovery patterns five years post-onset. Methods A retrospective review of prospectively collected data from a National Cardiothoracic Transplant Unit was conducted for 2019–2025. Annual volumes were compared to 2019 baselines, with subgroup analyses by procedure and acuity. Results Total annual cardiothoracic cases dropped to 49% of 2019 levels in 2021 (251 vs 510) before a gradual recovery: 73% in 2022, 87% in 2023, 91% in 2024, and 96% in 2025. Early pandemic impacts were most pronounced in 2021, with January-April volumes at 27% (40 vs. 149). Procedure-specific trends varied: CABG surgery recovered to 103% by 2024 (319 vs. 309); valve surgery exceeded baseline at 116% by 2025 (116 vs. 100); Aortic surgery reached 78% by 2025. Transplant numbers fell 52% from 2019 to 2020 (52 vs 25) and have failed to increase since, still sitting at half of 2019 volumes. Heart transplants are at 33–67% (5–10 vs 15) and lungs at 35–51% (13–19 vs 37) of pre Covid levels per annum. Acuity remained relatively unchanged during the study period. Conclusions Cardiothoracic surgery volumes largely recovered by 2024, but transplants volume as well as aortic procedures have failed to recover to pre COVID levels. These findings underscore the need for targeted interventions to address backlogs and enhance transplant services in Ireland.
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Walsh et al. (2026) conducted an observational in Cardiothoracic surgery and transplantation (n=2,980). COVID-19 pandemic vs. Pre-pandemic baseline (2019) was evaluated on Total annual cardiothoracic cases. The COVID-19 pandemic reduced cardiothoracic surgery volumes to 49% of baseline in 2021 with recovery to 96% by 2025, while transplant volumes fell by 52% and remain at half of pre-pandemic levels.
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