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Patients forced to wait longer as COVID-19 outbreak delays organ transplants

Doctor says organ donations, surgeries are down
Posted at 3:13 PM, Mar 27, 2020
and last updated 2020-03-27 19:30:00-04

NASHVILLE, Tenn. (WTVF) — Organ donations have always been a matter of life or death, but the COVID-19 outbreak is threatening operations and many more lives.

Phyllis Blake of Hopkinsville had a liver transplant scheduled at Vanderbilt University Medical Center this Monday after battling decades of cirrhosis of the liver. Her 24-year-old granddaughter was qualified to be her living organ donor but received a disappointing call several days ago.

“Things were moving quickly which was pretty good and all of a sudden, things were put to a halt,” granddaughter Katie Noland said.

Blake’s liver transplant was postponed to late April or early May because of the outbreak, but that could always change. The family is worried because she may lose the window of opportunity to receive a living transplant as her health deteriorates.

“My biggest fear is not receiving a transplant,” Blake said.

“The hospital said that waiting for a deceased donor, she probably wouldn’t make it because it takes so long,” Noland said.

Blake is just one example of how COVID-19 is disrupting procedures and hopes for a better life. Dr. Seth Karp of the Vanderbilt Transplant Center, one of the largest donor and transplant hospitals in the nation, said with the risk of recipients contracting the virus post-surgery and having complications during their recovery, surgeries are being delayed.

Transplants are considered an essential medical procedure, and Karp’s team is still performing surgeries on a case by case basis. The majority of people who come to them is in dire need of a new organ and will undergo surgery once it’s available.

However, Karp said there are patients that their current status allows them to have their transplants postponed. For example, kidney recipients have the ability to wait since they can be on dialysis allowing for a long wait time.

“There are certain recipients that perhaps are not as sick than some other recipients and we have that conversation with them if they would prefer to move ahead with the risk of getting the virus or prefer to wait,” Karp said. “When patients do have that option to wait, we are advising them to probably wait.”

Doctors are concerned patients with life-threatening health issues who don’t receive a transplant are unlikely to survive as COVID-19 slowly depletes the number of organ donations and stalls surgeries significantly.

Karp points to two potential reasons: people are scared of being exposed to the virus if they donate and with fewer people out amid the pandemic, there are less traumas that would make more organs available.

Vanderbilt University Medical Center had nearly 600 surgeries last year. With how the trend is going so far, Karp believed that number will drop to just more than half.

The hospital averages about 70 to 80 donors a year but the numbers are already down at this time.

“It’s very likely that more people will die because they won’t be able to get transplants,” Karp said.

More than 115,000 people are waiting for a transplant that could save their lives, and an average of 20 people die daily waiting for an organ transplant, according to Donate Life Tennessee. More than 3,000 people need a transplant in Tennessee, primarily for a kidney.

The average wait time to receive a kidney at the Vanderbilt Transplant Center is about four years, but waiting for other organs like a liver can take only months. Depending on where the outbreak is in a few months, wait times could double if not more.

Patients waiting for a transplant have a low risk of getting the virus from the organ donor, according to the American Society of Transplantation. Donors are being screened for symptoms, and several organizations are testing some or all donors for COVID-19. So far there’s no reason to indicate the virus could be spread by blood or in the normal organ transplant procedure.

However, Karp said his hospital makes every effort to test the donors for the virus, but that testing may delay the surgery and the donor isn’t used.

AST said it doesn’t have specific information on whether a COVID-19 infection will be more severe in transplant recipients, but the risk is there. Health experts have warned that older people with underlying health issues are in more danger, but in states like California and Tennessee, most COVID-19 cases so far have been in people younger than 40 years old.

There’s also a severe shortage of blood as a result of COVID-19, with more than 150,000 fewer blood donations and 4,500 blood drives canceled, according to the American Red Cross. Healthy people are encouraged to call their local blood center and ask if they can donate blood.

To learn more about organ donation and ways to register, click on this link.