Life-saving organ transplant COVID-19 plunged during crisis

Tuesday, May 12, 2020 (Health Day News) -Coronavirus Pandemic Affects All Areas of Healthcare, New Research Shows Delays in Potentially Life-Saving Organ Transplants Did.

Researchers found that in the COVID-19 pandemic, transplants from deceased donors fell 51% between early March and early April across the United States. In France, meanwhile, these procedures fell by 91%.

Experts said the findings published online May 11 Lancet, Don’t be surprised.

They said the numbers largely reflect efforts to protect patients and address the diversion of hospital resources to COVID-19.

Most of the reduction was in kidney transplants, as it is the most common organ transplant. But it is also because people with advanced kidney disease can continue dialysis while waiting for donor organs, said David Klassen, Chief Medical Officer of the Shared Organ Network (UNOS).

As a result, kidney transplants are generally less urgent than heart, liver, and lung transplants, Krassen said.

UNOS is a non-profit organization that manages the US organ transplant system. The new survey results are based on that data, but no survey has been conducted.

“US transplants haven’t stopped,” Klassen said. “But obviously, we want them to be as secure as possible.”

Dr. Peter Reese, an associate professor at the University of Pennsylvania Philadelphia, was part of the research team.

“The good news is that we’ve been going through the worst COVID-19,” he said. But although some transplants may be delayed, Reese added that patients on the waiting list for donor organs are definitely missing the opportunity.

“The tragedy is that we will never come back because there are dead donor organs that the patient did not receive,” he said.

According to UNOS, more than 112,000 Americans are currently on the waiting list for donor organs. Over 94,000 of them require kidneys. Kidney patients can get dialysis, but not always the time they need. Each year, approximately 9,000 patients on the waiting list must die or be removed from the queue due to poor health.

When COVID-19 struck the United States, most grafts from living donors-which can be rescheduled-were temporarily put on hold. One of the reasons was to protect donors from possible exposure to viruses in hospitals, Krassen said.

Transplant patients also require many hospital resources, including intensive care beds. If living donors are involved, that means two patients for each procedure.

At the outset, US transplant centers didn’t know if all cities “look like New York”, said Dr. Stephen Pastan, director of medicine for the kidney and pancreas transplant program at Emory University in Atlanta.

“The hospital was prepared for the worst,” said Pastan, a board member of the National Kidney Foundation.

“In Emory,” he said, “we took a cautious approach and closed our kidney program.”

It also took time to implement the test protocol nationwide. According to Pastan, transplant recipients should be screened for coronavirus infections to prevent them from being brought to the hospital.

Meanwhile, according to the American Transplant Society, organ-sourcing organizations have begun testing viral donors.

Now Pastan said, “The program is slowly increasing again.”

The current survey of data through April 10 does not capture more recent trends. According to UNOS Classen, there are no signs of further declines in US transplants.

The decline across the US centers, although significant, was less severe than the 91% decline in France.

Pastan said it is likely to reflect differences in the medical system. In the United States, individual transplant centers have decided what to do.

Reese made a similar claim.

“There was no rehearsal for COVID’s dress,” he said. “But it’s clear now that the spread of infections across the country is uneven. We’re approaching the idea that customization is possible, depending on the location of the transplant center.”

Even in areas with few cases of COVID-19, safety concerns remain.

One is whether organ recipients are at increased risk of severe coronavirus infection shortly after transplantation. The most powerful regimen is to suppress the immune system and avoid organ rejection.

Pastan says there is no evidence at this time. However, he added that transplant patients “assume high risk” and should follow all recommended precautions to avoid exposure to the virus.

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