The number of solid organ transplants fell dramatically around the world between 2019 and 2020, researchers have found, highlighting the widespread impact of the Covid-19 pandemic on health services and patients.
As the pandemic surged, hospitals were forced to delay potentially life-saving organ transplant surgery, because of resources such as intensive care beds being needed for Covid patients and because of concerns including whether it was safe to treat transplant recipients in hospital.
In July a report from NHS Blood and Transplant showed that in the year 2020-21, transplant activity was down to around 80% of normal levels, with 3,391 transplants carried out in the UK compared with 4,761 in the previous 12 months. Overall 487 patients died while waiting for a transplant compared with 372 in 2019-20, while the service estimated that about 7,000 people were likely waiting for a transplant in the UK – a figure it said was last seen in 2012-13.
Now an international study, published in the journal Lancet Public Health and presented at the European Society for Organ Transplantation (Esot) congress 2021, has showed the overall number of kidney, liver, lung, and heart transplants from human donors fell by 31% during the first wave of Covid-19 across 22 countries. The overall drop was almost 16% by the end of 2020, with more than 11,200 fewer transplants carried out.
“Temporal trends revealed a marked worldwide reduction in transplant activity during the first three months of the pandemic, with losses stabilising after June, 2020, but decreasing again from October to December 2020,” the team wrote.
The study looked at the number of the transplants carried out in each country until the end of 2020, starting from the point in the year at which 100 Covid cases were confirmed. These figures were then compared with those for the same time period the year before.
The results showed that the impact of the pandemic varied across countries: while there was a 9.86% overall drop in the number of organ transplants carried out in Canada during that period, corresponding to 227 fewer transplants; there was a 66.71% drop in Japan, where 1,413 fewer transplants were carried out.
Kidney transplants were the most affected, with a 19.14% decrease when all 22 countries were taken together, corresponding to 8,560 fewer transplants.
The team said this was “probably due to the non-immediate life-saving nature of this surgery and the possibility to postpone procedures”.
“The data also suggests living transplants saw a greater decline that those from deceased donors, with the researchers noting there may have been additional logistical and ethical difficulties as well as concerns around exposing living donors to Covid in hospitals. In some areas, living donor kidney and liver transplantation ceased,” they added.
Researchers said that while some countries experienced large reductions in transplant numbers others did not even though hard hit by Covid, meaning further analysis is required on a regional, national and global level to understand the differences.
