COVID-19 impacts Australia’s organ donation program DonateLife

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Lucinda Barry
By
The Organ and Tissue Authority
Lucinda Barry
CEO
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In February, we launched the 2020 Australian Donation and Transplantation Activity Report, with Federal Minister Mark Coulton MP, outlining the significant impact of COVID-19 on Australia’s national program to increase organ donation for transplantation.

Since 2009, we’ve run the DonateLife program in conjunction with state and territory health departments, the DonateLife Network, hospitals, clinicians and the community. In addition to raising awareness in the community and asking people to register their intent to be a donor, the program is underpinned by a best practice clinical program now embedded in 95 hospitals and delivered by 275 specialist donation doctors, nurses and support staff.

During the past two decades Australia’s organ donation rate has more than doubled, with transplants increasing by more than 80 per cent. However, with the impacts of COVID-19 there was a 12 per cent decrease in the number of people receiving a transplant and a 16 per cent decrease in the number of donors compared to 2019.

With a truly national program, there were numerous challenges faced during the year which means donors, recipients, retrieval teams and families were often not in the same location or even state.  DonateLife and transplant teams went over and above to navigate these challenges in hospitals and the logistics of COVID restrictions, given significant flight reductions and border closures. 

Also at the start of the pandemic, the transplant sector took precautionary steps and suspended the adult kidney and pancreas transplant programs from late-March through to mid-May. This was due to the real concern about hospitals being overwhelmed by COVID-19 patients and also to understand risk of immunosuppressed transplant patients being exposed to the virus.

While life-saving heart, lung, liver and paediatric transplants continued for those patients who were at high risk of dying without a transplant, during this time there were fewer procedures. However, as transplant programs across Australia resumed on a case-by-case basis, transplant and donation numbers began to increase.

While the results were lower than previous years, they exceeded earlier predictions, given in April the impacts were more than a 25 per cent decrease. This not only reflected the hard work and resilience of the dedicated donation and transplantation sector but the amazing generosity of families who said yes to donation when asked.

I want to acknowledge and sincerely thank the 463 deceased organ donors and their families that gave the gift of an organ – a life-changing gift for another Australian and their family.

Many people may not know, but the opportunity to be an organ donor is quite rare. A person needs to die in a hospital, usually ventilated in the intensive care unit or emergency department with their organs functioning well to have the chance to donate. There are also medical conditions which prevent donation. In 2020 of the approximately 80,000 deaths in hospitals, only about 1250 Australians – about two per cent of those who die in hospital – had the opportunity to become an organ donor.

Many more people have the opportunity to become eye and tissue donors as they do not need to die in a hospital and donation can occur up to 24 hours after death. Donated eyes, heart values, skin, bone and amnion can have significant life enhancing benefits to those in need. Both eye and tissue donations were also impacted during the year with 13 per cent and 7 per cent decreases respectively.

Despite the numerous challenges posed by the pandemic, around 4,000 Australians still benefitted from the gift of deceased organ, eye and tissue donation from 1,644 deceased organ, eye and tissue donors in Australia.

It is critical the donation and transplant clinical programs continue to navigate the ongoing challenges of the pandemic and that we also continue to engage with the broader community to raise awareness about donation and encourage families to talk about it and register as we know these has a direct impact on family consent in the hospital.

Our national consent rate in 2020 also decreased to 58 per cent. This is not unexpected with COVID restrictions on hospital visitors, including some conversations with families about end-of-life and potential donation of their loved one needing to be done virtually. I cannot imagine how difficult this was for families.

If Australia was to increase its consent rate to 75 per cent, we estimate 300 more people would receive a transplant. With a current waitlist of around 1650, with more than 12,000 additional people on dialysis who may benefit from a renal transplant, ultimately we need more Australians to say “yes” to donation.

We need to encourage all Australians to reflect on the life-changing benefits of organ and tissue donation. If they support donation, register at donatelife.gov.au and make sure we all have the all-important conversation with family, so they know you want to be donor if they are faced with this decision at the end of your life.

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