Tuesday, August 31, 2021

Organ transplants fell by a third worldwide during first wave of Covid-19 pandemic, new study shows


The number of solid organ transplants performed during the first wave of Covid-19 in 2020 plunged by 31% compared to the previous year

Peer-Reviewed Publication

EMOTIVE

(Milan, Tuesday 31 August, 2021) The number of solid organ transplants performed during the first wave of Covid-19 in 2020 plunged by 31% compared to the previous year, according to a new global study presented today at the European Society for Organ Transplantation (ESOT) Congress 20211.

According to 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 the 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 per cent) transplants. For deceased donor transplants, there was a reduction in kidney (-12 per cent), liver (-9 per cent), lung (-17 per cent) and heart (-5 per cent) transplants.

The research, published today in the Lancet Public Health, highlighted how some countries managed to sustain the rate of transplant procedures whilst others experienced serious reductions in the number of transplants compared to the previous year and, 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.

Dr Olivier Aubert, Assistant Professor at the Paris Translational Research Centre for Organ Transplantation and lead author of the study, commented, “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.” 

Professor Alexandre Loupy, head of the Paris Translational Research Center for Organ Transplantation and last author of the study, furthered, “Living donor transplantation, which reduced more substantially, requires significant resources and planning compared to deceased donor transplantation. 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.”

“It’s clear that there are many indirect deaths associated with Covid-19 and our study confirms that the pandemic has far-reaching consequences on many medical specialties.” added Prof. Loupy.

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.

Dr Aubert added, “Beyond the near universal reduction in transplant activity, certain countries and regions managed to carry-out procedures despite major challenges presented by the pandemic. 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.”

To facilitate understanding of the temporal trends and consequences of the pandemic on worldwide, national, and regional solid organ transplant activities for researchers, clinicians, and public health authorities, the authors created an open-access dashboard that presents data interactively for solid organ transplant activities and COVID-19 cases.

 

Change in the overall observed solid organ transplant counts between 2020 from the date of the first 100 reported cumulative COVID-19 cases until the end of follow-up (latest date of available data through December 31st 2020) and the same period of time in 2019, by country and organ

Nation

Overall

Kidney

Liver

Lung

Heart

Argentina, N. (%)*

-564 (-60·91%)

-429 (-64·32%)

-107 (-56·61%)

-8 (-47·06%)

-20 (-37·74%)

Austria, N. (%)

-56 (-10·22%)

-53 (-17·91%)

6 (5·08%)

0 (0%)

-9 (-16·36%)

Belgium, N. (%)

-166 (-22·46%)

-78 (-22·67%)

-49 (-20·68%)

-16 (-17·39%)

-23 (-34·85%)

Brazil, N. (%)

-2174 (-28·9%)

-1735 (-32·89%)

-307 (-16·51%)

-50 (-56·82%)

-82 (-27·42%)

Canada, N. (%)

-227 (-9·86%)

-229 (-16·29%)

5 (1·09%)

4 (1·47%)

-7 (-4·24%)

Chile, N. (%)*

-47 (-54·02%)

-23 (-46·94%)

-10 (-45·45%)

-6 (-85·71%)

-8 (-88·89%)

Croatia, N. (%)

-85 (-37·28%)

-35 (-36·84%)

-34 (-33·01%)

0 (NaN%)

-16 (-53·33%)

Finland, N. (%)

-48 (-13·68%)

-38 (-15·38%)

5 (9·26%)

-5 (-20·83%)

-10 (-38·46%)

France, N. (%)

-1410 (-28·96%)

-1041 (-34·28%)

-219 (-19·04%)

-101 (-31·27%)

-49 (-13·65%)

Germany, N. (%)

-328 (-10·53%)

-236 (-13·15%)

-46 (-6·5%)

-36 (-11·32%)

-10 (-3·4%)

Greece, N. (%)*

-11 (-12·22%)

-6 (-8·7%)

-2 (-14·29%)

1 (Inf%)†

-4 (-57·14%)

Hungary, N. (%)

-132 (-37·29%)

-79 (-37·26%)

-27 (-39·71%)

0 (0%)

-26 (-43·33%)

Italy, N. (%)

-525 (-16·18%)

-296 (-16·17%)

-162 (-15·25%)

-40 (-30·08%)

-27 (-12·27%)

Japan, N. (%)

-1413 (-66·71%)

-1112 (-69·63%)

-257 (-67·45%)

-18 (-26·47%)

-26 (-36·11%)

Netherlands, N. (%)

-187 (-17·64%)

-166 (-21·15%)

-7 (-4·46%)

-19 (-21·35%)

5 (17·24%)

Norway, N. (%)

-24 (-7·12%)

-6 (-2·99%)

3 (4·11%)

-6 (-22·22%)

-15 (-41·67%)

Portugal, N. (%)

-156 (-24·19%)

-67 (-19·76%)

-75 (-33·63%)

-10 (-15·62%)

-4 (-21·05%)

Slovenia, N. (%)

7 (8·43%)

7 (21·21%)

-2 (-9·52%)

6 (66·67%)

-4 (-20%)

Spain, N. (%)

-1033 (-24·02%)

-745 (-26·89%)

-176 (-18·6%)

-88 (-26·19%)

-24 (-9·68%)

Switzerland, N. (%)

-6 (-1·34%)

-7 (-2·69%)

-15 (-11·63%)

6 (20%)

10 (34·48%)

United Kingdom, N. (%)

-1298 (-31·31%)

-1076 (-35·54%)

-147 (-17·95%)

-69 (-47·92%)

-6 (-3·87%)

United States, N. (%)

-1370 (-4·13%)

-1110 (-5·44%)

-91 (-1·23%)

-237 (-10·18%)

68 (2·25%)

Overall, N. (%)

-11253 (-15·92%)

-8560 (-19·14%)

-1714 (-10·57%)

-692 (-15·51%)

-287 (-5·44%)

 

*Argentina, Chile, and Greece follow-up ended earlier than other countries due to data availability. Argentina ends on 2020-08-18, Chile end on 2020-05-27, and Greece ends on 2020-07-28. The remaining countries include through December 31st 2020. †There were no lung transplants in Greece in 2019.

 

ENDS

Notes to Editors:

A reference to the ESOT Congress 2021 must be included when communicating the information within this press release.

Please note that the open-access dashboard providing data for solid organ transplant activities and COVID-19 cases will go live during the Congress. To access the dashboard, please visit: www.covidtransplants.org

For further information, to access the full paper or to request an expert interview, please contact Luke Paskins or Sean Deans at press@esot.org or call +44 (0) 208 154 6396.

About the Expert:

Dr Olivier Aubert is an assistant professor and nephrologist at the Necker Hospital, Paris, France. He also has a PhD in biostatistics from the Paris Translational Research Centre for Organ Transplantation.

Prof. Alexandre Loupy is a professor and nephrologist at the Necker Hospital, Paris, France. He is also the head of the Paris Translational Research Centre for Organ Transplantation.

About ESOT:

The European Society for Organ Transplantation (ESOT) was founded over 30 years ago and is dedicated to the pursuit of excellence in organ transplantation. Facilitating a wealth of international clinical trials and research collaborations over the years, ESOT remains committed to its primary aim of improving patient outcomes in transplantation. With a community of over 8,000 affiliates from around the world, ESOT is an influential international organisation and the facilitator of the biennial congress which hosts approximately 3,500 experts who come to meet to explore and discuss the latest scientific research. For more information visit: https://esot.org/

About the ESOT Congress 2021:

The ESOT Congress 2021, taking place in-person and on-line and in Milan, Italy, features the latest research and innovation from the most prominent scientists and physicians in the field of organ transplantation. For more information visit:          https://www.esotcongress.org/

References:

  1. COVID-19 Pandemic Consequences On Worldwide Organ Transplantation: a population-based study. Presented at the ESOT Congress 2021.

 

Disclaimer: AAAS and EurekAlert! ar

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