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A considerable drop in the number of organ transplants since the start of the COVID-19 pandemic in France and the United States

A Franco-American study conducted by teams from the University of Paris, Inserm and AP-HP published in The Lancet reveals a drop of more than 90% in the number of organ donations and transplants during the COVID-19 pandemic in France. The trend, which is also being confirmed across the Atlantic, poses a life-threatening risk to the thousands of people waiting for transplants in France and the United States.

Society
Health

As the health crisis of COVID-19 began in France, organ transplant programme managers expressed concern about the continuation of organ transplant activity during the epidemic. There were two main reasons for this: the considerable burden of COVID-19 patient care on the health system and the increased risk of infection for transplanted and therefore immunocompromised patients. The recommendations were to maintain only urgent transplants, including heart and liver transplants, when the hospital organisation allowed it. A team from the University of Paris, Inserm and AP-HP, in collaboration with American researchers, evaluated for the first time the effect of the COVID-19 pandemic on organ procurement and transplantation worldwide. The Lancet published their study: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31040-0/fulltext Using data collected from French and American health agencies, the research team has highlighted the link between the COVID-19 outbreak and organ transplantation procedures. The evolution over time of the number of COVID-19 infections compared to the number of organ transplants in France and the United States shows: - an overall reduction in transplantation activity from deceased donors of 90.6% in France and 51.1% in the United States since the beginning of the outbreak of COVID-19, - a correlation between the increase in COVID-19 infections and the reduction in the total number of organ transplants, particularly pronounced for kidney transplants, - a significant decrease in the number of heart and liver transplants, even though these are usually urgent and vital operations. While the number of COVID-19 cases and deaths in France and the United States was on the rise, researchers found a dramatic decrease in organ retrieval and transplantation in both countries. Some of these transplants may prove vital to patients, particularly in the case of liver or heart transplants. These unrealised transplants represent a loss of potential organs from deceased donors. These organs, which are so precious and so eagerly awaited by thousands of patients, will not be recoverable after the COVID-19 health crisis. "The results of this study could be useful to public health agencies, learned societies, and patient advocacy organisations both in strategic terms and in terms of risk minimisation. They also make it possible to quantify the loss of organ transplant opportunities and to help strategies for resuming transplant activities after the epidemic peak", says Dr. Christian Jacquelinet, co-author of the study published in The Lancet and a public health specialist at the Agence de la Biomédecine and Inserm. "Using the example of organ transplantation, a highly regulated procedure that has a daily monitoring system of the activity in France and the United States, this study illustrates how a pandemic event can impact certain crucial medical activities, with immediate consequences for vulnerable patients," says Prof. Alexandre Loupy, lead author of the study and Director of the Paris Transplant Group Inserm U970 research team, also attached to the University of Paris and a nephrologist at the Necker Enfants Malades hospital.

Keywords

Covid-19, Transplantation, greffe d'organe, coronavirus, pandémie