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Has the COVID-19 Pandemic Affected Brain Death Notifications and Organ Donation Time?
Gulbahar Caliskan1, Ayca Sayan, Isa Kilic
1From the Department of Anesthesiology and Intensive Care, Ministry of Health, Bursa City Hospital, Bursa, Turkey.
Insights
The COVID-19 pandemic significantly reduced deceased organ donation rates and prolonged the donation process. Strategies are needed to improve organ donation, including infection control, during public health crises.
Area of Science:
- Transplant Surgery
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic created unprecedented public health challenges, impacting transplant waitlists.
- Global organizations issued recommendations for transplant procedures, including donor/recipient screening and perioperative management.
Purpose of the Study:
- To investigate the efficacy of new recommendations during the COVID-19 pandemic.
- To assess the impact of SARS-CoV-2 infection on deceased organ donation rates, organ management, and procurement timelines.
Main Methods:
- Retrospective evaluation of potential brain-dead donors between July 2019 and November 2020.
- Comparison of demographic and clinical features, time to confirmation, and acceptance rates before and during the pandemic.
Main Results:
- The number of brain-dead donors decreased from 13 pre-pandemic to 27 during the pandemic.
- Organ procurement decreased from 2 donors pre-pandemic to 3 of 8 during the pandemic.
- Organ donation time significantly increased from 8.5 hours pre-pandemic to 54 hours during the pandemic.
Conclusions:
- Deceased organ donation rates declined significantly during the COVID-19 pandemic.
- The organ donation process duration was substantially prolonged.
- Enhanced infection control and revised strategies are crucial for improving organ donation rates during pandemics.
Objectives:
The outbreak of coronavirus disease 2019, known as COVID-19, has rapidly evolved to a global pandemic. This pandemic represents an unprecedented public health issue not only for the general population but also for patients on the transplant wait list. Multiple organizations around the world have published recommendations for the proper conduct of transplant procedures, including donor and recipient screening and perioperative management. We investigated the efficacy of these new recommendations and the effects of SARS-CoV-2 infection on the deceased donation rate, donor organ management, and the time from family consent to procurement.
Materials And Methods:
The characteristics of potential donors diagnosed with brain death between July 15, 2019, and November 18, 2020, were evaluated retrospectively.Demographic and clinical features,the time elapsed from the clinical diagnosis until confirmation, and rates of acceptance were recorded. Potential donors diagnosed with brain death before the pandemic and during the pandemic were compared according to these variables.
Results:
Within the study period, 40 patients were diagnosed with brain death: 13 before the pandemic and 27 during the pandemic. The organs from 2 donors were procured before the pandemic. Organs from 3 of 8 donors were procured during the pandemic (the organs from 5 of these 8 patients were not donated). The organ donation time was 8.5 ± 2.12 hours (minimum-maximum, 7-10 hours) in the period before the pandemic and 54 ± 11.53 hours (minimummaximum, 45-67 hours) during the pandemic.
Conclusions:
The number of donors decreased significantly in our hospital during the pandemic and was similarto the overallrate inTurkey.The duration of the donation process has been prolonged, and strategies to improve rates of organ donation, including infection control, have become a focus of concern.
