The COVID-19 crisis has disrupted all facets of life, which isn’t any news for half of the world’s population currently living under lockdown. What’s really insidious about this medical crisis is that the effects of the pandemic have trickled down to non-coronavirus patients, threatening their lives due to either the collapse of local healthcare systems or disruption of procedures.
Case in point, France and the United States, two of the hardest-hit countries by the pandemic, are experiencing dramatic drops in both organ harvesting and transplants.
According to a recently published analysis by researchers at the University of Pennsylvania School of Medicine, transplant centers in both countries have conducted far fewer transplants from deceased donors in early April compared to just a month earlier.
In the United States, the drop in the number of transplants from deceased donors was about 50% while France experienced a staggering 91% drop in transplants.
“Our findings point to the far-reaching and severe ripple effects of the COVID-19 outbreak on health care, including life-saving organ transplants,” said study co-author Peter Reese, an associate professor of Medicine and Epidemiology at Penn.
“Organs from deceased donors represent a time-limited opportunity, as they must be procured and used rapidly. However, in order to protect the safety of their patients, centers must now carefully vet all donors to ensure there is minimal risk of COVID-19.”
The number of kidneys and liver transplants from live donors has been steadily increasing over the last decade. However, the vast majority of organs are procured from deceased patients. Of the 40,000 transplants performed in the U.S. in 2019, 32,000 involved organs from deceased donors.
Due to the pandemic, organ procurement has tanked due to fears that organs might come from donors who were infected or exposed to the coronavirus. In addition, many hospitals where both procurement and transplants were made are now dealing with COVID-19 cases, which has overridden their typical procedures for transplants.
After organs are harvested following a donor’s death, there’s a very short time window in which the transplant can be made. Some organs can last longer than others on the ice, but typically a transplant should be made no later than 24 hours after procurement.
On average, 20 people die each day waiting for an organ in the United States and a new name is added to the national transplant waiting list every 10 minutes. There are more than 112,000 people in total on the national transplant waiting list.
In order to investigate how organ procurement from deceased donors has been impacted by the pandemic in the U.S. and France, the Penn State researchers analyzed validated national data from three federal agencies, including the United Network for Organ Sharing (UNOS).
According to the results, the number of recovered organs dropped from 110 a day on March 6 to fewer than 60 per day on April 5. Kidney transplants, the most common procedure of its kind, dropped from 65 a day to 35 per day during the same timeframe.
France experienced an even sharper reduction, with organ transplants dropping by more than 90%. This is likely due to much harsher restrictions aimed at reducing clinical and commercial activity than in the United States.
It’s a tragedy that so many people are now left without a transplant, a reminder that the coronavirus doesn’t necessarily need to infect people to kill.
But as the pandemic progresses and local authorities gain new insights on how the virus spreads and earn experience in mitigation and suppression, studies such as these will inform public health leaders on how to proceed further.
Mapping specific trends in organ donation and transplant activity, for instance, will help to identify where donations and transplants are abnormally low.
“These international comparisons of transplant activity will be very important as the COVID-19 pandemic evolves,” said co-author Alexandre Loupy, a nephrologist at the Department of Nephrology and Kidney Transplantation at Necker Hospital in Paris and Head of the Paris Transplant Group.
“Some transplant systems may develop best practices to support organ procurement and transplant that can be shared across borders. We have a lot of work ahead to restore our invaluable infrastructure of donation and transplant surgery.”
The findings were reported in the prestigious medical journal The Lancet.
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