How COVID-19 has affected organ donation
In 2019, surgeons across the U.S. performed a record high number of organ transplant procedures (39,719), according to the United Network for Organ Sharing (UNOS). More than 19,000 living and deceased donors gave the gift of life by providing kidneys, livers, lungs, hearts and other vital organs to people in desperate need.
That need remains great, with more than 109,000 people currently on the U.S. organ transplant waiting list. But with the COVID-19 pandemic ongoing, are organ donation and transplant surgery still safe? Yes, says Dr. Fauzia Butt, a transplant surgeon at Penn State Health Milton S. Hershey Medical Center. "We've put protocols in place so that we can continue performing these lifesaving operations in ways that are safe for patients and health care providers."
The Centers for Medicare and Medicaid Services considers transplant surgeries to be high acuity, with the same status as trauma operations, lifesaving cardiac procedures and operations performed to prevent amputation. As a result, transplants involving deceased donors continued uninterrupted even during the height of the COVID-19 pandemic. Through Sept. 6, U.S. surgeons had performed 429 more deceased donor organ transplants this year than at this time in 2019, according to UNOS, the organization that manages the list of all people in the U.S. awaiting an organ transplant.
Recipients of organs from living donors typically don't have the same urgency as those awaiting organs from deceased donors and these cases are considered to be more elective in nature. So, as COVID-19 cases soared last March, almost all U.S. transplant centers suspended living donor transplants. At the Milton S. Hershey Medical Center, "we suspended living donor transplants in March and restarted them on May 14, once we felt it was safe to resume," Butt said.
Those shutdowns led to a decrease in living donor transplants nationwide; through Sept. 6, U.S. surgeons had performed 1,361 fewer living donor transplants in 2020 as compared to the same time last year.
The suspension of living donor transplants gave hospitals time to implement new safety measures. Since March, protocols have been developed in conjunction with infection prevention experts, to screen all recipients and living donors at Hershey Medical Center. Living donors and transplant recipients must now undergo an initial telephone screening for symptoms and exposures to COVID-19 before coming to Hershey Medical Center. All patients receive a nasal swab test for COVID-19 and recipients also undergo a low-dose chest CT to confirm the absence of radiographic signs of viral pneumonia. "If patients test positive for COVID-19 or shows signs of viral pneumonia on that CT scan, they cannot proceed with transplantation at this time," Butt said. Similar testing protocols have also been developed to screen deceased donors.
"So far, no living donors or patients transplanted at Hershey Medical Center since the viral pandemic began have tested positive for COVID-19," Butt said.
The new safety protocols are in addition to standard COVID-19 precautions practiced hospital-wide, including mask wearing, appropriate social distancing, visitor restrictions and employee and patient temperature screening. Patients are educated in continuing to follow the prescribed guidelines after being discharged from the hospital.
Finding suitable organ donors remains a priority in central Pennsylvania and throughout the nation. The National Kidney Foundation estimates the average time a kidney transplant recipient spends on the waiting list is between three and five years, although this may be longer depending on geographic location. Each transplant operation potentially reduces the time spent on the waiting list for the next recipient.
People interested in signing up for the organ donor registry or learning more about the process can do so at DonateLife.net. One organ, eye and tissue donor can save eight lives and improve the lives of another 75 people. Those who want to be living organ donors should call Hershey Medical Center at 717-531-6092 to learn more.
"There are always people in need," Butt said. "Don't let the fear of contracting or transmitting COVID-19 prevent you from potentially saving a life. We will perform all necessary testing to keep you safe and to make sure that donation is medically suitable for you."