Postponed

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.

“That equation changes depending on what area of the country you’re in,” agreed Dr. Abhinav Humar, transplant chief at the University of Pittsburgh Medical Center. His transplant center, still running, has taken in patients from New York and other harder-hit areas who needed a new liver, had a willing living donor and “can’t afford the luxury of waiting two or three months at least” in hopes their original hospital could take them back.

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.

“We’re one of the few centers that kept going through all of this, but it was not without a lot of careful thought,” said Freise, who needed daily updates in deciding what transplants were safe to schedule – and remains on guard as California’s social distancing restrictions are gradually lifted.

For example, Freise’s team allowed living kidney transplants for people like Herb Hoeptner, who was on the brink of needing dialysis.

“When you have kidneys that have nothing left, you either go on dialysis or you die. That was much more of a concern to me than coronavirus,” said Hoeptner.

The 66-year-old from Gilroy, California, realized only after his surgery on March 31 how rare a transplant during the pandemic was.

“I was extremely lucky,” added Hoeptner, whose wife, Diane, was his donor and rebounded quickly from the surgery.

In places where COVID-19 is more widespread, living donors are understandably nervous. “We don’t yet have a way to talk to living organ donors about what’s a reasonable risk,” said Penn’s Reese.