'Striking' Drop in Organ Transplants Seen With COVID-19 Pandemic

By Anne Harding

May 12, 2020

NEW YORK (Reuters Health) - The COVID-19 pandemic has led to a sharp drop in organ transplantation in the United States and France, a new report in The Lancet shows.

From late February to early April, deceased donor transplantations fell by 51.1% in the U.S. and by 90.6% in France, largely driven by a decline in kidney transplantation, although heart, lung and liver transplants also fell.

The authors, from the Paris Transplant Group and the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, belong to a growing consortium of countries sharing data on how the pandemic has impacted their transplant programs. To date, 12 countries have agreed to participate, study co-author Dr. Alexandre Loupy, a nephrologist at Necker Hospital in Paris and head of the Paris Transplant Group, told Reuters Health by phone.

"I think the international comparisons are going to be really vital. I see this research as the first step," co-author Dr. Peter Reese, an associate professor of medicine and epidemiology at Penn, said in a telephone interview.

As the pandemic hit in the U.S., most centers stopped performing living-donor kidney transplants, Dr. Reese noted. At Penn, "all other transplants were taking place on a case-by-case basis, and what you saw was that both the physicians and the patients were being a lot less aggressive about accepting organ offers."

Penn's census of COVID-19 patients and the number of patients with COVID-19 on ventilators has plateaued and is beginning to decline, he said, and the hospital is preparing to restart its living donor kidney program.

"What I expect going forward is a gradual liberalization or opening up to doing more transplants," Dr. Reese said. "Now that transplant centers have done two months of transplantation despite COVID, I think they're feeling more comfortable they can do it safely."

In France, organ transplantation ground to a virtual halt as the pandemic began to spread, Dr. Loupy said. "Basically everything shut down one day, and it was a kind of consensus achieved among professionals just because there was too much uncertainty around transplants."

The French National Transplant Society has issued a call for action to resume transplant activity, he added, and the country's procurement agency is investigating how best to restart.

Germany appears to have been able to maintain its transplant program through the coronavirus crisis, Dr. Loupy noted, and may offer lessons for other countries on coping with this pandemic, and future outbreaks.

"The good point about this crisis is the fact that we were pushed to work together in a more collaborative manner," he said. Data on the impact of the pandemic on transplantation may also be informative for other specialties, such as cardiovascular disease and cancer, that have been destabilized by the pandemic, he added.

SOURCE: https://bit.ly/2LlEIuJ The Lancet, online May 11, 2020.