{"id":30206,"date":"2020-04-21T14:17:15","date_gmt":"2020-04-21T19:17:15","guid":{"rendered":"https:\/\/www.tmc.edu\/news\/?p=30206"},"modified":"2020-06-11T00:20:06","modified_gmt":"2020-06-11T05:20:06","slug":"covidtransplantchanges","status":"publish","type":"post","link":"https:\/\/www.tmc.edu\/news\/2020\/04\/covidtransplantchanges\/","title":{"rendered":"COVID-19 has transformed the business of organ transplants"},"content":{"rendered":"

The COVID-19 global pandemic has slowed the transfer of vital organs for transplants. Testing for the disease caused by the novel coronavirus now extends to deceased persons who receive the same nasal swabs that make living patients flinch.<\/p>\n

The public\u2019s limited movement, thanks to stay-at-home orders and social distancing, means fewer of the accidents and other traumatic events that generate organ donation. Some people anticipating transplants have been inactivated, temporarily, from the national waitlist because of the coronavirus crisis.<\/p>\n

Despite a dwindling supply, surgeons are declining organs from coronavirus hot spots. In addition, concern about the availability of personal protective equipment (PPE) has halted live donor transplants at local transplant centers.<\/p>\n

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\u201cWe are not recovering organs and transplant centers are not transplanting organs from donors who have positive tests for COVID-19,\u201d said Kevin Myer, president and CEO of LifeGift<\/a>, a Houston-based organ procurement organization that serves 109 Texas counties and more than 200 hospitals, including transplant centers in the Texas Medical Center. \u201cDepending on where you are in the country\u2014obviously in New York and Seattle and in other places\u2014transplantation slowed down, but it didn\u2019t stop and it still hasn\u2019t stopped.\u201d<\/p>\n

The prospect of eclipsing 2019\u2014a record year for organ donations and transplants in the United States\u2014may be fading as COVID-19 cases continue to rise across the country.<\/p>\n

Still, the transplant community maintains hope, for now, especially because April is National Donate Life Month<\/a>.<\/p>\n

\"\"

LifeGift President and CEO Kevin Myer<\/p><\/div>\n

New procurement procedures<\/strong><\/p>\n

As part of the new pandemic procedure, a potential donor\u2019s next-of-kin is questioned about the person\u2019s travel history as well as exposure to various diseases and infections, including the novel coronavirus.<\/p>\n

\u201cWe are recovering a sample, a nasal swab, for COVID-19 testing,\u201d Myer said, adding that the additional process with test results in about 24 hours began in mid-March. \u201cIf we get a positive test back, we would stop the case.\u201d<\/p>\n

Other adjustments in the acquisition of organs include restricting travel. Typically, a LifeGift perfusionist and transplant surgeons recover an organ in person. Now, operating surgeons depend on their capable counterparts to match an organ in one place to a patient in another.<\/p>\n

The shift has affected LifeGift\u2019s donor and transplant tallies, which dropped by about half from February to March.<\/p>\n

\u201cFor March, we recovered 31 organ donors and transplanted 97 organs. For us, that\u2019s a little bit lower than what we typically do in a month, but we did not experience the massive drop some other areas have had. For tissue donors, we are also very close to what we planned for March,\u201d Myer said. \u201cFor our whole first quarter, we are right on track. Part of the reason for that is that you had the busiest level of activity that we ever had. We recovered 54 organ donors and transplanted about 186 organs in February.\u201d<\/p>\n

Transplant centers adjust<\/strong><\/p>\n

After attending a late-February transplant conference in Phoenix where a Canadian colleague left early because of his country\u2019s public health emergency, J. Steve Bynon, M.D.<\/a>, chief of abdominal transplantation at Memorial Hermann-Texas Medical Center<\/a>, returned to Houston and assembled his team to discuss COVID-19.<\/p>\n

\u201cI said: \u2018This is going to be a major problem. We need to not expose our patients. We don\u2019t know who has it and who doesn\u2019t; that\u2019s one of the problems without extensive testing. We need to cancel all of our post-transplant clinics because those people are immunosuppressed and we don\u2019t want to expose them, potentially, to other people who have it,\u2019\u201d Bynon recalled.<\/p>\n

The hospital turned to telemedicine options for recently discharged transplant patients. Live transplants were canceled to save PPE and ventilators.<\/p>\n

\u201cWhen you have a health care crisis like this, you have to change gears very quickly and conserve resources,\u201d Bynon said. \u201cWe decided we would not take organs from areas of the country that had high incidences of COVID. We would not take any organs from donors that we thought would be high risk from their method of death, such as unknown respiratory illness. Now, every donor is tested for COVID. Between those three criteria, we make a decision about whether we would accept those organs or not.\u201d<\/p>\n

\"\"

Steve Bynon, M.D., left, chief of abdominal transplantation at Memorial Hermann-Texas Medical Center, performs surgery.<\/p><\/div>\n

Transplant candidates are also screened with nasal swabs. Both donors and recipients also may receive a bronchoscopy, an endoscopic visualization of the airways, as well as a chest CT scan that might reveal COVID-19 characteristics in those who are asymptomatic.<\/p>\n

A month passed before the Memorial Hermann team could get rapid COVID-19 testing on donors. Even then, tests are sensitive about 70 percent of the time, \u201cso you are missing about 30 percent of the infections,\u201d Bynon said. \u201cThe more information you have, the better decisions you can make to make it as safe as possible for your patients.\u201d<\/p>\n

He has participated in conference calls to share ideas with other TMC surgeons including Osama Gaber, M.D.<\/a>, director of the J.C. Walter Jr. Transplant Center at Houston Methodist; John Goss, M.D.<\/a>, director of liver transplantation at Baylor St. Luke\u2019s Medical Center; and Christine O\u2019Mahony, M.D.<\/a>, surgical director of kidney transplantation at Baylor St. Luke\u2019s and the Michael E. DeBakey VA Medical Center. Goss and O’Mahony are also on the transplant teams at Texas Children’s Hospital.<\/p>\n

Bynon, who is also a professor of surgery<\/a> at The University of Texas Health Science Center at Houston (UTHealth)<\/a> McGovern Medical School<\/a>, has been tethered to an international online discussion of \u201cfascinating\u201d threads, he said, from transplant surgeons around the world\u2014particularly those in Italy and China. He\u2019s up at 5:30 every morning reading their dispatches and advice, then jumps back online after dinner.<\/p>\n

\u201cThat kind of ready access to information is vital for your patients,\u201d he said. \u201cWe have a lot of unknowns.\u201d<\/p>\n

LifeGift still operating<\/strong><\/p>\n

Donors and transplants reached all-time highs in 2019, according to the United Network for Organ Sharing (UNOS)<\/a>, the nonprofit that manages the country\u2019s organ transplant system under contract from the U.S. government.<\/p>\n

So far in 2020, transplants nationwide declined in mid-March<\/a> and began to fall behind last year\u2019s record trajectory in early April.<\/p>\n

While the number of weekly transplants nationwide hovered around 800 for the first two months of 2020, that number dipped to between 400 and 600 per week by the middle of March.<\/p>\n

\"\"<\/p>\n

Myer expects the local numbers to remain lower until the summer.<\/p>\n

\u201cWe think that our activity levels will actually drop off in April and May and then we think in June and July things will come back up and, by July, we will be back to a new normal,\u201d he predicted.<\/p>\n

For now, the LifeGift call center and other vital operations are remote but fully operating. LifeGift continued working through Hurricane Harvey in 2017, Myer noted, and has done so through this disruption as well.<\/p>\n

\u201cWe have a virtual platform. Our call center is fully remote. A lot of our staff who do hospital development are doing that virtually to minimize traffic in and out of the hospitals,\u201d he said. \u201cPeople still want to donate. People are in the hospitals counting on us right now. That whole concept of \u2018we offer hope\u2019 is probably more<\/em> true now than ever.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Organ donations and transplants nationwide and in Houston have declined since March because of the coronavirus crisis<\/p>\n","protected":false},"author":28,"featured_media":30215,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[1],"tags":[4375,4484,4665,3109,246,4666,171,1053,1054,4664,3922],"yoast_head":"\nCOVID-19 has transformed the business of organ transplants - TMC News<\/title>\n<meta name=\"description\" content=\"Organ donations and transplants nationwide and in Houston have declined since March 2020.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.tmc.edu\/news\/2020\/04\/covidtransplantchanges\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"COVID-19 has transformed the business of organ transplants - TMC News\" \/>\n<meta property=\"og:description\" content=\"Organ donations and transplants nationwide and in Houston have declined since March 2020.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.tmc.edu\/news\/2020\/04\/covidtransplantchanges\/\" \/>\n<meta property=\"og:site_name\" content=\"TMC News\" \/>\n<meta property=\"article:published_time\" content=\"2020-04-21T19:17:15+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2020-06-11T05:20:06+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.tmc.edu\/news\/wp-content\/uploads\/sites\/2\/2020\/04\/Liver_Kidney-Trans-01_2013-24.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"799\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Cindy George\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Cindy George\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.tmc.edu\/news\/2020\/04\/covidtransplantchanges\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.tmc.edu\/news\/2020\/04\/covidtransplantchanges\/\"},\"author\":{\"name\":\"Cindy George\",\"@id\":\"https:\/\/www.tmc.edu\/news\/#\/schema\/person\/fc1e2ff5366fa93667a13f9b7f7a97ec\"},\"headline\":\"COVID-19 has transformed the business of organ transplants\",\"datePublished\":\"2020-04-21T19:17:15+00:00\",\"dateModified\":\"2020-06-11T05:20:06+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.tmc.edu\/news\/2020\/04\/covidtransplantchanges\/\"},\"wordCount\":1245,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/www.tmc.edu\/news\/#organization\"},\"image\":{\"@id\":\"https:\/\/www.tmc.edu\/news\/2020\/04\/covidtransplantchanges\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.tmc.edu\/news\/wp-content\/uploads\/sites\/2\/2020\/04\/Liver_Kidney-Trans-01_2013-24.jpg\",\"keywords\":[\"coronavirus\",\"COVID-19\",\"J. 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