Effects of the COVID-19 Pandemic on Solid Organ Transplantation During 2020 in Poland Compared with Countries in Western Europe, Asia, and North America: A Review

Abstract

Self financingThe coronavirus disease 2019 (COVID-19) pandemic, due to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which began in March 2020, affected organ donor acceptance and rates of heart, lung, kidney, and liver transplants worldwide. According to data reported to POLTRANSPLANT, the number of solid organ transplants decreased by over 35% and the number of patients enlisted de novo for organ transplantation was reduced to 70% of its pre-COVID-19 volume in Poland. Most transplant centers in Western Europe and the USA have also drastically reduced their activity when compared to the pre-pandemic era. Areas of high SARS-CoV-2 infection incidence, like Italy, Spain, and France, were most affected. Significant decreases in organ donation and number of transplant procedures and increase in waitlist deaths have been noted due to overload of the healthcare system as well as uncertainty of donor SARS-CoV-2 status. Intensive care unit bed shortages and less intensive care resources available for donor management are major factors limiting access to organ procurement. The impact of the COVID-19 outbreak on transplant activities was not so adverse in Asia, as a result of a strategy based on experience gained during a previous SARS pandemic. This review aims to compare the effects of the COVID-19 pandemic on solid organ transplantation during 2020 in Poland with countries in Western Europe, North America, and Asia.

Lung transplantation from donation after circulatory death, evolution, and current status in the United States

“…Even though the entire volume of lung transplantation in the US differs greatly with other countries, lung transplants carried out using DCD lungs accounted for in more than 30% of all lung transplants in The Netherlands and Australia 10,11. Lung transplants from DCD donors continue to increase, although the overall number of lung transplants decreased between 2020 and 2021; this was most likely due to the COVID-19 pandemic that affected the number of transplants worldwide [12][13][14]. Lung transplantation from DCD lungs without EVLP showed an upward trend in our analysis.…”

Assessing the impact of COVID-19 on the performance of organ transplant services using data envelopment analysis

“…Firstly, the need to allocate as many ICU beds as possible for COVID-19 patients, implied a lower availability of ICU beds for transplant services [ 57 ]. Secondly, the reduced availability of staff during the pandemic (due to the need to treat COVID-19 patients and due to high infection rates of the professionals) also implied that fewer human resources were available to perform transplants [ 4 ]. Thirdly, the reduced number of potential donors, related with the reduced number of neuro critical patients’ admissions and also with the risk regarding the donor’s being infected with SARS-CoV-2 meant that less organs were available to be transplanted [ 58 ].…”

“…While important progress has been made in organ transplantation in the last decades, with improvements in surgical methods, organ preservation and pharmaco-immunologic therapies [ 3 ], recent evidence suggests that the COVID-19 pandemic might have detrimentally impacted the provision of this type of healthcare services [ 4 ]. This is particularly concerning as it might have affected the number of those able to timely benefit from the clinical improvements achieved in organ transplantation.…”

How COVID-19 Affects Lung Transplantation: A Comprehensive Review

“…Surprisingly, this phenomenon did not affect lung, heart, nor living donor liver transplants, due to less stringent donor acceptance criteria. However, all kidney transplantations and deceased donor liver transplantations were severely affected [ 25 ].…”