Organ Transplants Fell By A Third Worldwide During First Covid-19 Wave

A new global study has found that the number of solid organ transplants performed during the first wave of Covid-19 in 2020 plunged by 31% compared to the previous year. The findings were published in the peer-reviewed science journal Lancet Public Health. 

According to the modelling calculations, the slowdown in transplants resulted in more than 48,000 years of patient life loss. The research leveraged international data from 22 countries across four continents and revealed major variations in response of transplant programmes to the Covid-19 pandemic, with transplant activity dropping by more than 90 per cent in some countries.

Kidney transplantation showed the largest reduction across nearly all countries during 2020 compared to 2019, with the study finding a decrease in living donor kidney (-40 per cent) and liver (-33%) transplants. For deceased donor transplants, there was a reduction in kidney (-12%), liver (-9%), lung (-17%) and heart (-5%) transplants.

The research highlighted how some countries managed to sustain the rate of transplant procedures while others experienced serious reductions in the number of transplants compared to the previous year. In some areas, living donor kidney and liver transplantation ceased completely. Overall, there was a strong temporal association between increased Covid-19 infection rate and reductions in deceased and living solid organ transplants.

“The first wave of Covid-19 had a devastating impact on the number of transplants across many countries, affecting patient waiting lists and regrettably leading to a substantial loss of life,” said Olivier Aubert, assistant professor at the Paris Translational Research Centre for Organ Transplantation and lead author of the study.

The study confirms that the pandemic has far-reaching consequences on many medical specialties. “Living donor transplantation, which reduced more substantially, requires significant resources and planning compared to deceased donor transplantation,” said Alexandre Loupy, head of the Paris Translational Research Center for Organ Transplantation and a co-author of the study. “This is extremely difficult during a pandemic when resources are stretched and staff redeployed. There are also major ethical concerns for the wellbeing and safety of the donor.”

The estimated numbers of life-years lost were 37,664 years for patients waitlisted for a kidney, 7,370 for a liver, 1,799 years for a lung, and 1,406 for a heart, corresponding to a total 48,239 life-years lost.

Researchers said that these findings warrant further analysis on a regional, national and global level to understand why reductions did or did not occur. “Understanding how different countries and healthcare systems responded to Covid-19-related challenges can facilitate improved pandemic preparedness and how to safely maintain transplant programmes to provide life-saving procedures for patients,” said Aubert.

The authors have also created an open-access dashboard that presents data interactively for solid organ transplant activities and Covid-19 cases. This was done to facilitate understanding of the trends and consequences of the pandemic on worldwide, national, and regional solid organ transplant activities for researchers, clinicians, and public health authorities.

There were early concerns of the pandemic disrupting overall health facilities, and increasing evidence is now beginning to make clear the extent of the impact.