Introduction: The Multi-Organ Transplant (MOT) Program serves children of British Columbia and the Yukon. Families may travel upwards of 2,500 kilometres (km) several times a year to attend in-person clinical appointments. The COVID-19 pandemic required a change in healthcare practices, with some in-person appointments being replaced with virtual appointments. We sought to estimate the potential reduction in patient travel and greenhouse gas (GHG) emissions that accompanied this change in clinical practice. 
Methods: Our study cohort included all heart, kidney, liver and lung transplant patients currently followed by our program. All patient appointments between April 1, 2020 and March 31, 2022 were reviewed. Driving distance, driving time and GHG emissions were estimated using specialized geocoding software. Carbon dioxide equivalents (CO₂e) were used as a surrogate for GHG emissions and estimated for five motor vehicle fuel efficiencies. We report the results for a fuel efficiency of 10L/100 km.
Results: The study cohort included 148 (57% male) patients. There were 29 (20%) heart, 66 (45%) kidney, 51 (34%) liver and 2 (1%) lung transplant recipients who were transplanted at a median age of 4.8 years. Of the 1035 MOT appointments recorded during the study period, 194 (19%) were held virtually. The median travel distance and travel time from home to MOT clinics were 43.2 km and 42.5 minutes, respectively. Cumulative driving distance and time during the study period would have been 306,729 km and 3,978 hours, respectively, if all appointments were held in-person. Virtual appointments would save 90,549 km and 1,092 hours of travel. If all appointments were held in-person, the cumulative CO₂e would approximate 124.839 tonnes (t). Virtual appointments would save 36.853t, a 30% reduction in CO₂e.
Conclusion: While patient travel to MOT clinics is essential for some appointments, others may be held virtually. These virtual appointments significantly reduce patient travel and GHG emissions.