This week is Donate Life Week, a campaign which encourages all Australians to have ‘the talk’ about organ and tissue donation. We spoke to Dr Rebecca Davis, consultant Microbiologist and physician in Infectious Diseases at a major metropolitan hospital in NSW, to discuss whether COVID-19 has had an impact on organ donation and what measures have been introduced.

“The impact of COVID-19 on transplantation nationally in Australia has varied depending on the transplanted organ. Some units temporarily suspended transplantation, such as kidney, while other life-saving transplants such as heart, liver or lung continued cautiously. Most live donor transplants were also deferred during this time. Overall however, the impact from COVID-19 has not been dramatic, especially compared to other countries with higher rates of COVID-19.

“We originally saw a dip in donor numbers in March and April at the beginning of lockdown due to conservative decision making about appropriate donor candidates. Subsequently, donor numbers have improved back to similar levels seen in previous years.

“Some patients have had to stay on dialysis longer than they might have otherwise due to the deferral of some non-urgent transplantation. However, this is to reduce the risk of them contracting COVID-19 after transplant when they would be highly immunosuppressed.

“Patients were phoned to inform them of these decisions and the risks, benefits and impacts are being closely investigated to make sure that future transplant decisions are appropriate, and evidence based. This includes a study using online focus groups to obtain patient, family member and potential donor perspectives on the suspension and resumption of kidney transplant programs due to COVID-19 which was published last month,” said Dr Davis.

Currently, all solid organ transplantation is going ahead, though on a cautious basis. Some centres may suspend transplantation again depending on COVID-19 numbers in their area. Whilst there has been a decrease in the number of patients receiving kidney transplant this year, the number of patients receiving other organs is not too dissimilar to previous years.

Potential donors who are at risk of COVID-19 are excluded from donation and all other donors are tested for COVID-19 with a polymerase chain reaction (PCR) test prior to donation. In some states, recipients also have testing for COVID-19 before they receive a transplant. Many hospitals are doing this via rapid PCR testing, which requires a responsive laboratory service.

“Organ transplantation cannot go ahead without a large group of healthcare workers, scientists and others working together. There is an enormous input required from pathology services “behind the scenes” in order for transplantation to take place. Recipients are screened for a range of infectious and other diseases, such as diabetes, hepatitis and tuberculosis infections, to allow timely treatment and prevention of complications.

“Donors and recipients have extensive testing to make sure that the organ and recipient will be matched by blood type and tissue compatibility. The donor is also screened to make sure that they don’t have any infections that might be passed on through the donor organ. It has been gratifying to see how closely different groups have worked together during this pandemic to provide ongoing care to those impacted by transplantation,” said Dr Davis.