Deceased donor solid-organ transplantations dropped steeply after the COVID-19 outbreak in late February and early March – 91% in France and 51% in the United States, investigators reported in The Lancet.

In the United States, the number of recovered organs fell from more than 110 per day on March 6 to fewer than 60 per day on April 5. The number of transplanted kidneys dropped from nearly 65 to 35 per day over the same period.

Declines in kidney transplantation drove the trends in France and the US, but reductions in heart, lung, and liver transplants also contributed, Alexandre Loupy, MD, PhD, of Necker Hospital in Paris, France, and colleagues reported. France may have experienced a larger drop in deceased donor organ transplants because antivirus policies affected the entire nation, whereas individual states in the US had some leeway in their COVID-19 response.

Deceased donor organ transplantation rates declined even in regions with small numbers of COVID-19 cases, suggesting the pandemic had a “global and nationwide effect” the investigators discussed.


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Organ procurement and transplantation data were obtained from the National Organ Procurement Agency in France and the United Network for Organ Sharing in the US.

“These international comparisons of transplant activity will be very important as the COVID-19 pandemic evolves,” Dr Loupy stated in a news release from the University of Pennsylvania. “Some transplant systems may develop best practices to support organ procurement and transplant that can be shared across borders. We have a lot of work ahead to restore our invaluable infrastructure of donation and transplant surgery.”

In an April 23 webinar from the American Society of Nephrology, experts discussed myriad challenges and responses in kidney transplantation during the COVID-19 pandemic, including in wait list management, organ allocation, patient refusal of organ offers (due to concerns of contracting the virus in hospital or from the donor), and post-transplant care. 

Disclosure: One study authors declared affiliations with the pharmaceutical industry. Please see the original reference for the author’s disclosures.

References

Loupy A, Aubert O, Reese PP, Bastien O, Bayer F, Jacquelinet C. Organ procurement and transplantation during the COVID-19 pandemic [published online May 11, 2020]. Lancet. doi: 10.1016/S0140-6736(20)31040-0

Steep Decline in Organ Transplants Amid COVID-19 Outbreak [news release]. University of Pennsylvania; May 11, 2020.

Challenges in Kidney Transplant in the COVID-19 Pandemic: Implications for Patients & Providers. American Society of Nephrology; April 23, 2020.