Ann Liver Transplant.  2021 Nov;1(2):123-128. 10.52604/alt.21.0027.

Impact of COVID-19 on the number of deceased donors and organ transplantation in Western countries

• Park CS
• Park YH

• KMID: 2560861
• DOI: http://doi.org/10.52604/alt.21.0027

Abstract

The severe acute respiratory syndrome coronavirus 2 disease 2019 (COVID-19) pandemic has an impact on all facets of our health care system, including life-saving procedures. The COVID-19 in 2020 has a substantial impact on the transplant community. This study aimed to assess the impact of COVID-19 on the number of deceased donors and organ transplantation in Western countries by analyzing literature review. In Spain, the COVID-19 pandemic has posed significant challenges to the Spanish donation and transplantation program. The program activities decreased substantially during the most critical weeks of the first COVID-19 wave, but recovered over the next weeks to return to a reasonable level. In France, there was a 28% decrease in the number of organ donations and a 22% decrease in the number of liver transplantation in 2020. In Italy, a 47% reduction in organ donation and a 44% reduction in transplantation during the first 6 weeks of the COVID-19 pandemic compared with one year before. In the United States of America, the overall reduction in deceased donor transplantations since the COVID-19 outbreak was 51.1%, with the highest percentage of reduction in kidney transplantation. The present study revealed that there is a strong association between the increase in COVID-19 infections and a striking reduction in solid organ transplantation procedures. However, further studies are necessary to follow up and validate the results of this study.

Keyword

SARS-CoV-2; COVID-19; Deceased donor; Living donor; Organ transplantation

Figure

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  Figure 1 Changes in donation and transplantation activities by months in 2020 vs. 2019 in Spain. The number of deceased and living donors (A) and the number of solid organ transplantation (OTx) (B). Between January and September 2020, the number of deceased donation and solid organ transplantation decreased by 26% and 22%, respectively, compared with the corresponding period in 2019.

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  Figure 2 Time variations of the organ procurement (A) and liver transplantation (B) activities by months in early 2020 vs. early 2019 in France.

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  Figure 3 Trend of donors during the three evaluated periods in Italy. The figure plotted numbers of the total potential donors (A) and used donors (B) during the considered periods: period A (6 weeks after February 21, 2020); period B (6 weeks after February 21, 2019); and period C (6 weeks before February 20, 2020).

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  Figure 4 Trend of solid organ transplants during the three evaluated periods in Italy. The figure shows the numbers of total solid organ transplantations during the three considered periods: period A (6 weeks after February 21, 2020); period B (6 weeks after February 21, 2019); and period C (6 weeks before February 20, 2020).

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  Figure 5 Weekly rates of the deceased donor (A) and living donor (B) liver transplants performed between January and June 2020 in the United States of America. Marked reductions in liver transplantation were observed in March and April 2020. Living donor liver transplantation has continued to be performed seldomly throughout the month of April 2020.

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  Figure 6 Weekly rates of the deceased donor organ recovery between January and August 2020, in the United States. Significant decreases in organ recovery rates were noted at the height of the COVID pandemic in March 2020. A 25% reduction in organ recovery was observed between February and April 2020.

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  Figure 7 Trends in COVID-19 spread over time in France and the United States of America (USA) and recovery of organs and solid-organ transplantation procedures from deceased donors. Number of COVID-19-confirmed cases and number of solid organs recovered for transplantation over time in France (A) and the USA (C). Total number of deceased donor transplantations, with separate trend lines for kidney, liver, heart, and lung, over time in France (B) and the USA (D).

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