Transplantation in the era of coronavirus. The number of transplants is declining

In Poland, 2019 transplants were performed throughout 1473. The most common kidney and liver transplants. This year, the number may be even lower due to the COVID-19 pandemic. What does Polish transplantology look like in the era of a pandemic? What do patients have to deal with?

1. The coronavirus epidemic has hit Polish transplantology. Since the beginning of 2020, a total of 350 transplants have been performed. In the same period in 2019, this number was 451
2. – Many systemic factors contributed to the decrease in the number of transplants, while there are no legal barriers to transplant during an epidemic – says Attorney Aneta Sieradzka
3. The smaller number of transplants results, among others, from that some of the facilities have been transformed into single-name hospitals, which means that they do not report potential donors at all

The number of transplants in Poland will decrease

The COVID-19 pandemic has paralyzed Polish health care. In March, when the first case of the disease was confirmed in Poland, all forces were “deployed” to fight the pandemic. Infectious wards have become the most important in hospitals. Each voivodeship has homonymous hospitals that only treat patients with COVID-19.

However, the COVID-19 pandemic did not magically make other diseases disappear, and patients of cardiology, orthopedics and oncology departments recovered and did not need care. They still struggle with problems, and due to the situation in the country, they have problems with access to medical services. This situation also affects Polish transplantology – performing transplants in times of a pandemic is difficult, but not impossible.

The statistics published on the website of “Poltransplantu” show that in April 2020 only 54 transplants from deceased donors were performed – 32 kidneys, 9 livers, 8 hearts and 5 lungs. This is almost a half less than in the previous months (January – 111, February – 94, March – 91).

There are currently 2020 people on the 1999 National Transplant Waiting List. Most of them are waiting for a kidney transplant (1177), the heart is second (458) and the liver is third (153). 151 people are waiting for a lung transplant.

Since the beginning of 2020, a total of 350 transplants have been performed. In the same period in 2019, this number was 451. What does transplantation look like in the age of a pandemic?

See also: Polish transplantology is in trouble. Fewer and fewer donors and transplants

COVID-19 has exposed shortcomings in the health care system

The COVID-19 pandemic has highlighted what the Polish health care system has been struggling with for a long time. Staff shortages, underfunding of hospitals, generation gaps – all this caused confusion, which also affected the branch of transplantology.

– Transplantation procedure always carries medical and legal risks, which should be minimized and which should be communicated to the patient giving informed consent to the procedure. The state of the epidemic has increased this risk. Therefore, a number of recommendations and restrictions have been introduced to limit the patient’s infection from the stage of qualification, transplantation and after the procedure – explains lawyer Aneta Sieradzka from Kancelaria Prawna Sieradzka & Partners and the author of the blog “Transplant Law” in an interview with MedTvoiLokony.

The recommendations and restrictions mentioned by the expert were issued, among others, by Organizational and Coordination Center for Transplantation “Poltransplant” and national consultant in the field of clinical transplantation professor dr hab. Lech Cierpka, med.

«Poltransplant» did not recommend stopping organ transplants from deceased donors (suspended transplants from living donors), but informed about a number of restrictions and recommendations that are to ensure the safety of recipients and medical staff. It is important to test both donors and recipients for coronavirus infection. However, it is not such a simple matter.

– Access to COVID-19 tests is not universal, not only from the perspective of the patient, but also the medical staff, who is to ensure patient safety. The question is: how is he supposed to do this without always having the necessary tools? Infectious hospitals, the so-called unnamed names were excluded from the procurement and transplantation of tissues and organs, the activity of many other hospitals and departments that collected organs was suspended, e.g. due to the emergence of COVID-19 cases in them – explains Sieradzka and adds: – Many systemic factors contributed to the decline in the number of transplants, but there are no legal barriers to transplant during an epidemic.

The less transplants will be performed, the longer the wait will be. And waiting in line patients have very little time.

Difficulties in the field of transplantation during the SARS CoV-2 pandemic were also indicated by Dr. n. med. Artur Kamiński, director of the Polstransplantu.

– Fewer transplants are due to: limiting or even stopping living donation programs, reducing the reporting capacity by converting some hospitals into single-name hospitals, resulting in a lack of reporting from these hospitals Temporary exclusion of some hospitals or some of their departments due to infection with SARS CoV-2, as well as temporary exclusion of hospital employees from work as a result of quarantine or in connection with the reduced staffing of departments – lists Kamiński.

National consultant in the field of clinical transplantation prof. dr hab. Lech Cierpka, MD, recommended that organ transplants be limited to urgent cases only. As he said in an interview for “Puls medicin”, urgent cases are the least related to kidney transplantation, because in this case renal replacement therapy can be used.

“The decision to perform a transplant will only be made by the head of the transplant center. It is he who will judge which case is life-threatening. He will have to consider all the pros and cons – to consider whether it is necessary to take a risk and perform a transplant, ”Cierpka explained.

Patient in the “new reality”

The pandemic situation has affected all patients, not only those waiting for a transplant.

– First of all, patients should try to reduce fear and trust doctors, new procedures and restrictions aimed at their safety – says attorney Sieradzka.

Our expert also reminds that patients should use medical teleports, during which they will be able to send medical documentation to a doctor, they can also receive an e-prescription, referral or general recommendations. In the era of contradictory information, it is worth reaching for proven sources of knowledge, seeking advice from specialists and educating yourself.

Recommendations for patients in the COVID-19 era:

1. The Ministry of Health publishes recommendations regarding family births
2. How are preparations for childbirth going during the coronavirus epidemic?
3. Online medical advice at the National Health Fund. Where to call to consult a doctor?
4. From May 4, rehabilitation is back. Recommendations for physiotherapists and patients