Organ transplantations plummet amid coronavirus pandemic

By Angela Betsaida B. Laguipo, BSNMay 12 2020

The coronavirus disease has spread rapidly across nearly all countries across the globe, with more than 4.25 million people infected. The pandemic has taken a toll on the lives of people, especially those in locked down nations. Aside from the negative impact on economic and social aspects, patients who are sick with other diseases may also suffer from the effects of the pandemic.

For instance, the number of organ transplantations dropped in the United States by as much as half, worsening the world’s problem of a shortage of organs.

End-stage organ failure is estimated to affect more than 6 million people worldwide. In 2018, the transplant system across the globe provided the needed organs to 150,000 patients, which is far from the demand. In the United States, an estimated 40,000 patients receive an organ transplant each year, with another 120,000 on the waiting list. The demand for organs has long been a problem, with an estimated 7,600 people in the U.S. dying while waiting for an organ.

The coronavirus pandemic has worsened the already grim situation of organ transplantation worldwide. Due to the skyrocketing cases and nations placed on lockdowns, many health care providers and patients are worried about the potential effect of the coronavirus disease (COVID-19) may have on organ donation and transplantation.

Organ procurement and transplantation during the COVID-19 pandemic. The Lancet. Image Credit: Dan Race / Shutterstock

Major concerns

One of the significant concerns health care practitioners have on organ transplantation amid the pandemic is that those who receive new organs are susceptible to infection and increased viral burden. Further, due to the high demand for hospital admissions tied to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, there are limited resources in terms of staff and equipment to care for patients after organ transplantation.

During lockdowns, patients who are immunocompromised or those with underlying medical conditions are not advised to go out of their homes so as to reduce the risk of being infected. All these concerns have affected the number of organ transplants performed over the past months, leaving patients with worsening conditions.

Declines in organ transplant procedures

The researchers from Paris University in France have reported that organ transplantation procedures plummeted by about half in the United States and 90 percent in France between late February and early April. Their findings, published in the journal The Lancet, indicates the pandemic has worsened a shortage of vital organs, such as lungs, hearts, livers, and kidneys in both countries.

In the U.S., the number of such organs recovered from deceased donors for transplant reduced from about 110 per day on March 6, to nearly 60 by early April. In the same period, the number of kidney transplants decreased from 65 per day to about 35 per day.

Transplant experts have found that the decline worsened in France, where transplant procedures plunged by 91 percent. They tied the considerable decline to the nationally coordinated effort to cope with the coronavirus pandemic. In comparison, the U.S. government depended on state officials to impose restrictions.

Living donations can be rescheduled, but what is worrying is the number of missed organs from a deceased donor are lost opportunities.

“As COVID-19 spreads rapidly across Europe to North America, South America, and other continents, health-care providers and leaders of medical institutions will make difficult decisions about how best to deploy limited medical resources.5 These choices could be especially devastating for the thousands of patients in need of an organ transplant. While living donor organ transplants could presumably be rescheduled for a future date, deceased donor organs must be procured immediately, or the opportunity is lost,” the researchers said in the paper.

Ramping up again

More recent numbers by the United Network for Organ Sharing (UNOS) show that transplant started to increase again by late April. Some transplant systems may develop the best practices to help in organ procurement and transplant.

The doctors who deal with transplantations need to adapt to the new situation and provide reassurance to patients that the system will be back once the COVID-19 situation improves.

“Some organ procurement organizations and their networks will undoubtedly recover more quickly than others through best practices and effective communication with hospitals. Careful mapping will enable public health leaders and transplant organizations to identify areas where transplants have not recovered well, and support is needed,” the researchers said in the paper.