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. 2020 Nov;20(11):3089-3093.
doi: 10.1111/ajt.16157. Epub 2020 Jul 15.

There are no best practices in a pandemic: Organ donation within the COVID-19 epicenter

Amy L Friedman  1 , Kristin W Delli Carpini  1 , Chad Ezzell  1 , Helen Irving  1
Affiliations

There are no best practices in a pandemic: Organ donation within the COVID-19 epicenter

Amy L Friedman et al. Am J Transplant. 2020 Nov.

Abstract

LiveOnNY, the organ procurement organization (OPO) for the greater New York metropolitan area, suspended several best practices to manage the rising referrals of deaths from hospitals during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. On April 2, 2020 hospitals in the donor service area were notified that coronavirus disease 2019 (COVID-19) referrals should be deferred. Still, only 2% of referred patients to the OPO in April 2020 were on ventilators and considered possible organ donors, versus a baseline of 11% in 2019. Few of these deaths were unrelated to COVID-19. Accordingly, organ donors declined to 10 in April (from 26 in March). Despite the exclusion of marginal donors and organs, the implementation of COVID-19 donor testing, and the availability of local procurement surgeons, only 1 organ (a liver) was accepted by a transplant center outside of New York State and 8 organs (5 livers, 4 kidneys) were transplanted in state; 11 organs (1 liver, 10 kidneys) were discarded. Allocation was unsuccessful for 11 additional organs (1 liver, 4 kidneys, 4 hearts, 2 lungs). Despite the obstacles, organ donation remained an important model of collaboration and satisfaction for the health care community in the pandemic's US epicenter. Declining COVID-19 deaths led to the resumption of the comprehensive referral policy on May 6, 2020, with improvement to 18 donors in May.

Keywords: clinical research/ practice; donors and donation: deceased; infection and infectious agents - viral; organ procurement and allocation; organ procurement organization; social sciences.

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Figures

FIGURE 1
FIGURE 1
Deaths within the LiveOnNY donor service area from March 13, 2020 to May 31, 2020, as of June 9, 2020. Deaths reported from 98 hospitals in the 12 counties to LiveOnNY include patients on ventilators and those with asystole, as required by New York state (NYS) law. NYS coronavirus disease (COVID) deaths in 12 counties imputed to provide daily counts based on NYS aggregate data. The 2 populations do not completely overlap
FIGURE 2
FIGURE 2
Referrals of ventilator-dependent patient deaths to LiveOnNY from February 15, 2020 to May 27, 2020. Coronavirus disease 2019 (COVID-19) patient status was reported by the callers making the referrals
FIGURE 3
FIGURE 3
Organs transplanted from deceased donors recovered in the LiveOnNY donor service area from January 1, 2020 to May 31, 2020
FIGURE 4
FIGURE 4
Organs recovered for transplantation and discarded from LiveOnNY deceased donors from January 1, 2020 to May 31, 2020
See this image and copyright information in PMC

References

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