There are no best practices in a pandemic: Organ donation within the COVID‐19 epicenter. Issue 11 (15th July 2020)

• Record Type: Journal Article
• Authors: Friedman, Amy L.; Delli Carpini, Kristin W.; Ezzell, Chad; Irving, Helen
• Is Part Of: American journal of transplantation. Volume 20:Issue 11(2020)
• Page Start: 3089
• Page End: 3093
• Publication Date: 2020-07-15
• Subjects: clinical research/ practice -- donors and donation: deceased -- infection and infectious agents ‐ viral -- organ procurement and allocation -- organ procurement organization -- social sciences; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.16157
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : LiveOnNY, the organ procurement organization (OPO) for the greater New York metropolitan area, suspended several best practices to manage the rising referrals of deaths from hospitals during the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic. On April 2, 2020 hospitals in the donor service area were notified that coronavirus disease 2019 (COVID‐19) referrals should be deferred. Still, only 2% of referred patients to the OPO in April 2020 were on ventilators and considered possible organ donors, versus a baseline of 11% in 2019. Few of these deaths were unrelated to COVID‐19. Accordingly, organ donors declined to 10 in April (from 26 in March). Despite the exclusion of marginal donors and organs, the implementation of COVID‐19 donor testing, and the availability of local procurement surgeons, only 1 organ (a liver) was accepted by a transplant center outside of New York State and 8 organs (5 livers, 4 kidneys) were transplanted in state; 11 organs (1 liver, 10 kidneys) were discarded. Allocation was unsuccessful for 11 additional organs (1 liver, 4 kidneys, 4 hearts, 2 lungs). Despite the obstacles, organ donation remained an important model of collaboration and satisfaction for the health care community in the pandemic's US epicenter. Declining COVID‐19 deaths led to the resumption of the comprehensive referral policy on May 6, 2020, with improvement to 18 donors in May. Abstract : Organ procurement and donation in New York City requires adaptation of prior best practices, representing a unifying accomplishment for the entire healthcare community.