Impact of COVID-19 on brain death and organ donation; a single center study in Turkey
Abstract
Objectives: More than 50 million people in the world have been diagnosed with COVID-19 and more than 1 million 250 thousand patients have died. With the increasing number of COVID-19 patients admitted to hospitals, problems related to non COVID-19 patient care have emerged. Organ transplant organizations have had to adapt to this difficult time. The current and long-term impact due to the COVID-19 pandemic is an important factor to be taken into account. An important question to ask is how this outbreak has changed the organ donation process and how long it will take to address a potentially growing waiting list. Methods: We analized the effects of the pandemic COVID-19 in 2020 inTurkey between March and May. We have counted the number of brain deaths and organ donations in these months. We retrospectively compared the same months in 2019, the months before and after the pandemic in 2020, and the years 2019-2020. Results: When examined in other months, it is seen that the effect of the pandemic on brain death and organ donation continues not only in the months when the pandemic is intense, but also in other months. The total number of brain deaths in 2019 was 37, and family donations were 22; In 2020, the number of brain deaths decreased to 13, and family donations decreased to 7. This corresponds to a decrease of 64.86% and 68.18%, respectively, compared to the previous year. Conclusions: Brain death, organ donation and organ transplantation have decreased significantly with the onset of the pandemic compared to the previous years and the pre-pandemic period. Studies from different countries and regions have also shown that this decrease becomes even more pronounced where the number of cases is high.
References
2) Gorbalenya AE, Baker SC, Baric RS, et al. Severe acute respiratory syndrome-related coronavirus: The species and its viruses – a statement of the Coronavirus Study Group [Preprint]. bioRxiv; feb. 2020. doi: 10.1101/2020.02.07.937862.
3) Phelan AL, Katz R, Gostin LO. The novel coronavirus originating in Wuhan, China: challenges for global health governance. JAMA. 2020;323(8):709-10. doi: 10.1001/jama.2020.1097.
4) Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5.
5) Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. doi: 10.1016/S0140-6736(20)30566-3.
6) Cirrincione L, Plescia F, Ledda C, Rapisarda V, Martorana D, Moldovan RE, et al. COVID-19 Pandemic: prevention and protection measures to be adopted at the workplace. Sustainability. 2020;12(9):1-18. doi: 10.3390/su12093603.
7) World Health Organization. WHO Coronavirus (COVID-19) Dashboard [Internet]. Disponible en: https://covid19.who.int/ (consulta: 17/12/2020).
8) Sağlık Bakanlığı TC. Genel Koronavirüs Tablosu [Internet]. Disponible en: https://covid19.saglik.gov.tr/TR-66935/genel-koronavirus-tablosu.html (consulta: 17/12/2020).
9) Kumar D, Manuel O, Natori Y, Egawa H, Grossi P, Han SH, Fernández-Ruiz M, Humar A. COVID-19: A global transplant perspective on successfully navigating a pandemic. Am J Transplant. 2020;20(7):1773-9. doi: 10.1111/ajt.15876.
10) Martino F, Plebani M, Ronco C. Kidney transplant programmes during the COVID-19 pandemic. Lancet Respir Med. 2020;8(5):e39. doi: 10.1016/S2213-2600(20)30182-X.
11) Halazun KJ, Rosenblatt R. Lest we forget. Am J Transplant. 2020;20(7):1785-6. doi: 10.1111/ajt.15888.
12) Wall AE, Pruett T, Stock P, Testa G. Coronavirus disease 2019: utilizing an ethical framework for rationing absolutely scarce health-care resources in transplant allocation decisions. Am J Transplant. 2020;20(9):2332-6. doi: 10.1111/ajt.15914.
13) Levin A, Tonelli M, Bonventre J, Coresh J, Donner JA, Fogo AB, et al; ISN Global Kidney Health Summit participants. Global kidney health 2017 and beyond: a roadmap for closing gaps in care, research, and policy. Lancet. 2017;390(10105):1888-917. doi: 10.1016/S0140-6736(17)30788-2.
14) American Society of Transplantation. COVID-19 Resources for Transplant Community [Internet]. Disponible en: https://www.myast.org/covid-19-information (consulta: 17/07/2020).
15) Loupy A, Aubert O, Reese PP, Bastien O, Bayer F, Jacquelinet C. Organ procurement and transplantation during the COVID-19 pandemic. Lancet. 2020;395(10237):e95-e96. doi: 10.1016/S0140-6736(20)31040-0.
16) Ravanan R, Callaghan CJ, Mumford L, Ushiro-Lumb I, Thorburn D, Casey J, et al. SARS-CoV-2 infection and early mortality of waitlisted and solid organ transplant recipients in England: A national cohort study. Am J Transplant. 2020;20(11):3008-18. doi: 10.1111/ajt.16247.
17) Brindle ME, Gawande A. Managing COVID-19 in surgical systems. Ann Surg. 2020;272(1):e1-e2. doi: 10.1097/SLA.0000000000003923.
18) Manara AR, Mumford L, Callaghan CJ, Ravanan R, Gardiner D. Donation and transplantation activity in the UK during the COVID-19 lockdown. Lancet. 2020;396(10249):465-6. doi: 10.1016/S0140-6736(20)31692-5.
19) de Vries APJ, Alwayn IPJ, Hoek RAS, van den Berg AP, Ultee FCW, Vogelaar SM, et al. Immediate impact of COVID-19 on transplant activity in the Netherlands. Transpl Immunol. 2020;61:101304. doi: 10.1016/j.trim.2020.101304.
20) Domínguez-Gil B, Coll E, Ferrer-Fàbrega J, Briceño J, Ríos A. Dramatic impact of the COVID-19 outbreak on donation and transplantation activities in Spain. Cir Esp (Engl Ed). 2020;98(7):412-4. doi: 10.1016/j.ciresp.2020.04.012.
21) Roza BA, Mendes KDS. The Coronavirus pandemic and the impact on donation and transplantation in Brazil. Prog Transplant. 2020;30(3):292-3. doi: 10.1177/1526924820935413.
22) Angelico R, Trapani S, Manzia TM, Lombardini L, Tisone G, Cardillo M. The COVID-19 outbreak in Italy: Initial implications for organ transplantation programs. Am J Transplant. 2020;20(7):1780-4. doi: 10.1111/ajt.15904.
23) Cannavò A, Passamonti SM, Martinuzzi D, Longobardi A, Fiorattini A, Troni NM, et al. The impact of COVID-19 on solid organ donation: the North Italy Transplant Program Experience. Transplant Proc. 2020;52(9):2578-83. doi: 10.1016/j.transproceed.2020.06.025.
24) Moris D, Shaw BI, Dimitrokallis N, Barbas AS. Organ donation during the coronavirus pandemic: an evolving saga in uncharted waters. Transpl Int. 2020;33(7):826-7. doi: 10.1111/tri.13614.
25) Neidlinger NA, Smith JA, D'Alessandro AM, Roe D, Taber TE, Pereira MR, et al. Organ recovery from deceased donors with prior COVID-19: a case series. Transpl Infect Dis. 2021;23(2):e13503. doi: 10.1111/tid.13503.
26) Ting J, Wong YL. Challenges in organ donation during COVID-19 pandemic: a Singapore perspective. Int J Transplant Res Med. 2020;6:53. doi: 10.23937/2572-4045.1510053.
27) Shah MB, Lynch RJ, El-Haddad H, Doby B, Brockmeier D, Goldberg DS. Utilization of deceased donors during a pandemic: argument against using SARS-CoV-2-positive donors. Am J Transplant. 2020;20(7):1795-9. doi: 10.1111/ajt.15969.
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