Waiting lists have dramatically increased and the Covid-19 pandemic has had an immediate and devastating impact on transplant activity.
Johannesburg – August is Organ and Tissue Donor Month and the Organ Donor Foundation is once again appealing to families to open up the conversation around becoming a donor.
The foundation’s liaison officer, Julie Purkis, said while organ donations around the world have decreased by more than 90% in some countries, in South Africa donor transplants have come to a complete standstill. In the US, donations have dropped to 51% and 90.6% in France.
Waiting lists have dramatically increased and the Covid-19 pandemic has had an immediate and devastating impact on transplant activity as the infection became more widespread throughout the world, with South Africa being the most severely affected country in Africa.
“It’s not often that the entire world experiences a dramatic event that affects us all, but it’s a tremendous privilege when we find ourselves in a position to make a difference,” said Purkis.
“We all feel disempowered when something takes control of our lives, something that scares us, leading to feelings of immobilisation. However, in a crisis there is always something that we can do to make a difference. This is about the many unfortunate patients who right now need a transplant and who will surely die if a suitable donor is not found, but there is hope for this person – and that hope is us, who can immediately do something about it.”
Successful organ donation relies on many factors that have to fall into place. Donor hospitals have to make a timely referral of potential donors to organ procurement officers, who in turn need to co-ordinate with intensive care unitsto undertake the necessary testing and screening measures to exclude Sars-CoV-2 and pneumonitis caused by the virus.
Purkis added that to complicate matters, the high number of Covid-19 patients being admitted has led to hospital bed, ventilator and staffing shortages, with many doctors and nurses being reassigned to Covid wards, making it almost impossible to realise a potential organ procurement.
“An even more devastating factor is a result of hospital visitor restrictions, where family members cannot be present, which poses a significant barrier to obtaining timely donation consent from the next of kin. These many hurdles have led to health-care providers and leaders of medical institutions needing to make difficult decisions about how best to deploy limited medical resources,” Purkis said.
The foundation stressed that in South Africa, there is still capacity for transplant services, but it has been significantly limited by a lack of deceased donor referrals. To compound the crisis, living elective donations, which make up 50% of all transplants performed, have come to a complete standstill due to the Covid-19 restrictions.
Not only have half the transplants that would normally be carried out come to a halt, but it’s become incredibly difficult for deceased donations to take place. However, deceased transplantation will continue to take place in facilities that have sufficient staff and the infrastructure available.
Purkis said that in South Africa, organ and tissue donor consent is already difficult to obtain because people do not feel comfortable saying yes, to consent.
“This is an intensified call to action and collective effort to mobilise South Africans to not only register as organ and tissue donors, but to ask their friends and family to register too. We, the Organ Donor Foundation have in the past seen an increase in organ and tissue donor consent as a result of aggressive media drives. The more people who register and talk to their families, the more people will be saved.
“This is a crisis that can be addressed and it’s our social duty to act today and to continue acting for the month of August to help save lives that would otherwise be needlessly lost,” she said.
For a transplant to take place, a donor is needed who has a matching blood type, plus meets a range of criteria such as tissue typing and antibody cross-matching, which all has to match to a recipient. This is a complex process and can often disqualify a potential donor if a matching recipient cannot be found.
“It is, therefore, in the light of the Covid-19 pandemic, critical that the pool of available donors is bigger, to increase the chance for a suitable match. Now, more than ever, South Africans need to register as organ and tissue donors to increase the opportunity for transplantation,” Purkis said.
Anyone interested in becoming an organ and tissue donor can simply visit www.odf.org.za