Donors factors, anesthesia and critical care

Tuesday September 13, 2022 from 17:35 to 18:35

Room: CF-9

348.10 Impact of COVID‐19 on Organ Procurement in Argentine

Alejandro Sergio Yankowski Sr., Argentina

Evolution of brain deaths in the Argentine in 2019-2021
INCUCAI
INCUCAI

Abstract

Impact of COVID‐19 on organ procurement in argentine

Alejandro Yankowski1, Gabriela Hidalgo1, María E Barone1, Pablo Centeno1.

1Medical Direction, INCUCAI Instituto Nacional Central Coordinador de Ablación e Implante, Ciudad Autóinoma de Buenos Aires, Caba, Argentina

Introduction: There is no doubt that SARS-CoV-2 pandemic has had a negative impact on worldwide health care system. Several factors might have been affected the process of organ donation and recovery, such as adequate donor evaluation and consent, hospital resources among others. The aim of the present study was to analyze and compare the quality metrics in organ donation before and during SARS-CoV-2 pandemic.

Methods: A retrospective, descriptive study was conducted with data obtained from the Reporting Center of the Argentine National Transplant Information System (CRESI) before (2019) and during pandemic (2020 and 2021). Data collected included: brain deaths detected, real deceased donors, effective donors (donor from whom a perfused organ was removed and implanted in a recipient), multi-organ donors, opposition to the donation, total number communications for donation, and solid organ transplants performed with cadaveric donor.  The quality indicators used were: Donors per million inhabitants (DPMH); Conversion rate (CR = real donors/detected brain deaths); Effectiveness (Ef = Real donors/effective donors); multi-organ donor rate (MODR = multi-organ donors / actual donors); Opposition rate (OR = opposition to the donation/total communications made); solid organs procured by real donor (SOPRD = organs / real donors, and solid organ transplants performed with cadaveric donor (SOT = solid organ transplants / real donors).

Results: Table 1. The DPMH rate decreased by 50% in the first year of the pandemic, partially recovering in the second year with a 30% decrease compared to the pre-pandemic year. The CR was lower during 2020 compared to 2019, probably due to the epidemiological context and the logistical barriers. However, during 2021, the CR gradually increased likely due to the development of efficient protocols, a decrease in the number of COVID-19 cases, and the reorganization of human and technological resources, and improvements of the intensive care units. Surprisingly, the percentage of Ef of the donation process increased in both years of the pandemic, as did the rate of MODR. Regarding the OR, there was an increase in the first year of the pandemic but a decrease of 2 points in the second year of pandemic. Even though, all years analyzed the OR was below the desired 20 % value. Likewise, the SOPD and SOT slightly increased in pandemic compare to 2019.

Conclusions: Although the absolute numbers showed a significant decrease in organ donation during pandemic, the quality indicators of the donation process were maintained and even improved for the same period, probably due to the strategies executed with the aim to mitigate the impact of the pandemic due to SARS-CoV-2 over the donation, procurement and transplantation process.

Acknowledgement to Dr. Carlos Soratti for his support and stimulation to work.

Presentations by Alejandro Sergio Yankowski Sr.



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