Organ transplantation during the COVID-19 pandemic – impact on deceased organ donor referrals and consent rates in the Western Cape, South Africa

Abstract

Background: The impact of the COVID-19 pandemic on transplantation is multifactorial. This study reports on its influence on deceased donation for transplantation in the Western Cape.
Methods: The volume of referrals and those who were consented for organ donation in the province in the pre-pandemic period of May 2017 to February 2020 were compared to those of the initial pandemic period (March through December 2020).
Results: Prior to the pandemic, there were 201 deceased donor referrals in the Western Cape province – 152 (75.6%) and 49 (24.4%) in public and private sectors, respectively. The mean referral rates ranged between 59–69 referrals per year, translating into a monthly rate of 4.8 (range 2.8–5.8). During the first 10 months of the pandemic, there were 18 referrals – 12 (66.7%) and six (33.3%) in the public and private sectors; a decrease of 63%, with a mean monthly referral rate of 1.8. The overall consent rate prior to the pandemic in the public and private sectors was 36.6% (38% and 27%, respectively) with an increase to 44.4% (37.5% and 62.5%) during the pandemic.
Conclusion: Despite a 10% increase in consent rate for deceased donation during the COVID-19 pandemic, there was a significant decrease in the number of potential donors referred. Strategies to improve organ donation and transplantation during and after the COVID-19 pandemic are required.