Introduction: The current pandemic produced by COVID-19 has had a profound global impact on organ donation and the activity of different solid organ transplant programs around the world. This effect is even more pronounced in transplant programs in developing countries, such as central American and Caribbean region. Both central American and Caribbean have had significant deficiencies in logistics planning and the implementation of health policies that effectively support complex health programs such as organ transplantation. The current COVID-19 pandemic has aggravated this situation, where the absence of consensual policies and adapted protocols and delay in planning and implementation of urgent measures to address the serious situation of patients on the waiting list for an organ transplant, have been the norm.

Methods: In order to comparatively evaluate the impact of the COVID-19 pandemic on the rate of organ donation and transplantation in the Central American and Caribbean region, the data published regarding the activity of donation and transplantation by the Network/ Ibero-American Donation and Transplantation Council in their bulletins Vol.XV.N.1.2021 (pandemic period report) and Vol.XIV.N.1.2020 (pre-pandemic period report) was analyzed, to determine the differences in organ donation and transplant rates per million population, between the pre-pandemic period of 2019 and the pandemic period of 2020.

Results: The average rate of donation from deceased donors fell from an average from 4.25 to 1.82 pmp, the total kidney transplant rate declined from a mean of 9.48 to 3.77 pmp, the mean deceased-donor kidney transplant rate dropped from 5.32 to 2.25 pmp, the mean living-donor kidney transplant rate fell from 4.17 at 1.53 pmp, the mean liver transplant rate fell from 1.22 to 0.65 pmp and the mean rate of transplant patients dropped from 10.8 to 4.6 pmp.

Conclusions: The COVID-19 pandemic has produced a deep drop in the average rates of organ donation and organ transplants in the Central American and Caribbean region, producing a setback in the already weakened activity reached in 2019, to historical levels that mirror to the donation rates achieved a decade ago. Urgent changes in the creation of health policies, leadership, organization and optimization of resources based on ethical and scientific criteria are necessary to prevent this drop in donation and transplant activity, accentuated by the COVID-19 epidemic, from becoming a permanent setback in the opportunity of patients and that could take years, even decades to be reverse.