Organ and tissue donation are a selfless gift to the community as it helps to transform the quality of life as well as having cost benefits for society. Just one organ donor has the power to save the lives of up to 10 people and substantially improve the lives of many more.
In Australia in 2019, 1683 people were given a new chance at life by being the recipient of a successful organ transplant. 1,600 people were on the list waiting for a suitable organ to become available. Australia is among the world leaders in terms of success rate in organ transplants which is good news for people who need a new body part.
Not so good is the unexpected impact of the COVID Pandemic on organ donations. Normally, the Australian National Donor rate is 21.6 donors per million with the largest source of donors being deaths due to a motor vehicle accident. In fact, approximately 30% of donations result from mortality due to a car crash.
Reduction in Fatalities from Motor Vehicle Accidents
Since many people have been forced to isolate due to the current COVID Pandemic, we have seen a substantial decline in the number of motor vehicle accidents. In Australian there has been an average 25% reduction in deaths due to traffic collisions compared with data from 2019. Whilst this is a great outcome in terms of reducing trauma for families, it is not such great news if you are on the organ transplant waiting list.
In Australia in April, organ donor organisations usually see an increase in donations due to an increase in Easter holiday traffic and related outdoor activities and travel. This year people were forced to stay at home during the entire month of April, hence a dramatic decrease in the number of deaths by misadventure.
For the month of April 2020, the number of people who were organ donors and died in traffic accidents decreased by more than 25% on average with some states achieving above 33%. Easter holiday accidents were nearly non-existent with very few drownings, beach deaths, motorbike accidents, and motor vehicle collisions.
Medical staff has commented on the decrease in emergency room admissions overall due to the decrease in people moving about as well as Australia’s excellent performance in controlling Covid-19 transmission. Doctors and nurses have even noticed a decrease in people suffering from heart attacks and strokes during this period.
People who die from a heart attack or stroke while at home cannot have their organs transplanted because of a lack of blood flow. Successful organ donations occur when a person has a near-death event and efforts to save them are not successful. Generally, they pass away whilst being connected to a ventilator so blood is still flowing to their organs.
COVID19 measures decelerate transplant pipeline
The enormous activity around preparing for and protecting against Covid-19 transmission has also made life difficult for transplant patients. Most hospitals were forced to scale back other surgeries and to conserve the reserves of ventilators and protective medical equipment. Hence, most hospitals simply have not had the capacity for complicated organ recoveries, transportation, and implantation.
In Australia, transplant surgery largely ceased in Mid-March and at this time has not scaled back to the levels of 2019. For transplant surgery to be successful many critical factors need to be perfectly aligned.
Ventilators have been reserved for COVID19 patients who have been limited in Australia. For a transplant to be successful, organ donors need to be kept alive for 2 or 3 days while the transplant medical teams and receivers are made available. Then of course, the patient needs to be on a ventilator throughout the surgery and the following surgery.
The anxiety surrounding ventilator availability for pandemic patients made life exceedingly difficult for transplant patients. Ironically, some COVID-19 patients who died had registered their organs for donation but sadly could not be utitlised.
Medical staff has been devastated by the number of organs they had to reject.