Organ Procurement From Donors After Brain Death During the COVID-19 Pandemic: Experience of a High Prevalence Country.

ABSTRACT

OBJECTIVES: Our aim was to compare the donation process before and after the COVID-19 pandemic in an organ procurement unit in Iran and to discuss different strategies to address the impact of the pandemic on the donation process. MATERIALS AND METHODS: All activities including donor detection, donor selection, family approach, donors characteristics, rate of organs per donor, and types of organs were compared between 2 intervals over 18 months (March 2020 to June 2021 [during the COVID19 pandemic] vs November 2018 to February 2020 [before the pandemic]). RESULTS: Before and during the COVID-19 pandemic, there were 218 and 137 brain dead donors with mean age of 42.6 ± 14.5 and 42.8 ± 15.5 years, respectively (P = .82). The prevalence of tumors leading to brain death decreased by more than half during the COVID-19 pandemic (P = .04). There was a 52% increase in cardiac death before organ retrieval during the COVID-19 pandemic, reaching 38% from 25% before COVID-19. During the 2 intervals, the number of organs per donor was 2.3 ± 1.2 and 2.2 ± 1.2 (P = .52). The rate of actual to potential donors before and during the pandemic was significantly different, with 42.16 ± 7.8% before and 29.9 ± 4.8% during the pandemic, mostly as a result of unsuitable donors. The time to obtain family consent during the COVID-19 pandemic was 35.1 ± 8.5 hours, which was a significantly longer length of time than before the pandemic (21.3 ± 12.3 hours; P = .008). CONCLUSIONS: In our organ procurement unit, which encompasses a population of 5.5 million in Tehran, Iran, the number of actual donors was reduced dramatically during the studied pandemic period. However, despite a high workload, all transplant centers and organ procurement units in Iran worked to identify and transplant the available organs to reduce wait list mortality.