Organ transplants down amid outbreak
Counts show numbers inching up last month
WASHINGTON — Organ transplants plummeted as COVID-19 swept through communities, with surgeons wary of endangering living donors and unable to retrieve possibly usable organs from the dead — and hospitals sometimes too full even when they could.
Deceased donor transplants — the most common kind — dropped by about half in the U.S. and 90 percent in France from late February into early April, researchers reported in the journal Lancet.
Transplants from living donors had a similarly staggering dive, according to the United Network for Organ Sharing, which runs the U.S. transplant system. There were 151 living donor transplants in the U.S. in the second week of March when a pandemic was declared. There were only 16 such transplants the week of April 5, according to UNOS.
It’s too soon to know how many people waiting for a lifesaving organ transplant may die not from COVID-19 infection but because the pandemic blocked their chance at a new organ. Kidney transplants make up the vast majority of the drop, but heart, lung and liver transplants declined, too.
Living donations might be rescheduled, but missed organs from a deceased donor are lost opportunities, wrote Lancet lead author Dr.
Alexandre Loupy, a kidney specialist who heads the Paris Transplant Group.
More recent counts by UNOS show that transplants starting inching back in late April, with U.S. hospitals trying to decide how to safely rampup.
Geographic variation could offer important lessons, said another study author, Dr. Peter Reese of the University of Pennsylvania.
“Transplant centers and patients really want to get going again, but there are all these questions,” said Reese, whose team is collecting data from Canada and other parts of Europe for a closer look.
Hospitals worldwide have postponed all kinds of medical care as they were flooded with coronavirus patients. Transplants are among the hardest choices. They’re not elective surgeries. But patients must take immune-suppressing medicines to prevent rejection of their new organ — putting them at greater risk if they encounter the virus.
France’s larger drop may be due to more centralized public health policies than in the state-by-state variations in the U.S., Reese said.
In an average month, New York does about 220 transplants statewide. In the first weeks of April, that had dropped to 23, Samantha Delair of the New York Center for Liver Transplantation told a recent UNOS video conference.
In contrast, the University of California, San Francisco, in an area that has been less affected by the pandemic, has seen small transplant drops, said interim transplant director Dr. Chris Freise.