A study recently found that the number of solid organ transplants decreased around the world between 2019 and 2020, highlighting the widespread impact of the Covid-19 pandemic on hospital pressure.
The Covid-19 pandemic has put health systems around the world under pressure. Many establishments have indeed had great difficulty in containing the influx of seriously ill patients while ensuring the protection of their employees against the risk of infection.
On the patient side, there are the direct victims, but also the collateral victims. The hospital pressure encountered by a large number of countries because of the pandemic has indeed resulted in the postponement of many major surgical interventions. These include interruptions or delays in the treatment of many cancers. Organ transplants, often essential for patients with end-stage organ disease (longer survival and better quality of life), are another example.
-16% in one year
In July, a report from the NHS Blood and Transplant previously pointed out that transplant activity fell by 20% during the year 2020-2021 in the UK. A total of 487 patients had died while awaiting a transplant, compared to 372 the previous year. A new study published in the journal Lancet Public Health today shows that the total number of kidney, liver, lung and heart transplants fell by 31% during the first wave of Covid-19 in 22 countries. The decrease was nearly 16% over the year as a whole with more than 11,000 fewer transplants performed.
“Time trends have revealed a marked global reduction in transplant activity in the first three months of the pandemic, with losses leveling off after June 2020, but declining again from October to December 2020,” writes the team of researchers.
Globally, kidney transplants were the most affected with a decrease of 19.14% (8,560 fewer transplants), followed by lung, liver and heart. For these scientists, this is “probably due to the non-immediate nature of this surgery and the possibility of postponing the procedures”.
According to these results, transplants from living donors have declined more than those from deceased donors. For the researchers, this could be explained by logistical difficulties coupled with concerns about the exposure of living donors to Covid in hospitals potentially risking infecting transplant patients, and therefore immunosuppressed.
Disparities between countries
The researchers observed disparities by country depending on the impact of the pandemic. In Canada, the number of transplants fell by 9.86% (227 fewer transplants), while Japan has just suffered a drop of 66.71% (1,413 fewer transplants). In France, 1,410 transplants had to be postponed or canceled, which represents a decrease of 28.96%.
Conversely, some countries like the United States, Switzerland, Belgium and Italy have managed to maintain the rate of transplant procedures. Understanding how these different countries have been able to respond to the challenges of Covid-19 while safely maintaining their transplant programs will be essential to offer solutions in the future.