How doctors grappled with organ transplants during the pandemic

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During lockdown, Dr Jansz was part of a surgical team who performed a heart transplant on Emily Smith, 25, who was diagnosed with peripartum cardiomyopathy, a rare form of heart failure, six weeks after the birth of her son Hudson.

“A week after I was listed for a heart transplant I got the phone call to say I was having one. It was a scary, emotional call and a traumatic time… I missed Hudson’s whole second month.”

Heart transplant recipient Emily Smith, 25, with her son Hudson Glover in Zetland. Ms Smith underwent a heart transplant at St Vincent’s Hospital in September.

Heart transplant recipient Emily Smith, 25, with her son Hudson Glover in Zetland. Ms Smith underwent a heart transplant at St Vincent’s Hospital in September. Credit:Kate Geraghty

After the transplant, Ms Smith underwent another surgery to implant a temporary pacemaker and was discharged seven weeks later.

“Luckily I had everything on my side. I was relatively fit and healthy beforehand, so I recovered quickly.”

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National Transplantation and Donation Taskforce co-chair Steve Chadban said the state’s transplantation network had “coped amazingly well” despite a drop-off in organ donations.

“Two years ago we were on a high because there’d been ten years of increased organ donor numbers. And then suddenly, the pandemic hit,” Professor Chadban said.

“Now, organ donation numbers are down about 30 per cent across the country. We haven’t had the real bounce out of it that we were hoping for. But maybe it’s early days,” said

Professor Chadban said about sixty kidney transplant recipients in Australia have contracted COVID-19 over the past 18 months. Among them, the mortality has fluctuated between 10 and 15 per cent.

“Vaccines have been a big game changer because, even though vaccines don’t work as well in immunosuppressed people as the general population, data from the UK Data shows they reduce your risk of ICU admissions and death by about tenfold,” Professor Chadban said.

He said some reasons for the drop in organ donations had been the fall in consent rates from families and fewer major surgeries being performed.

Dr Paul Jansz, Director of the St Vincent’s Heart Lung Transport Unit in St Vincent’s Hospital.

Dr Paul Jansz, Director of the St Vincent’s Heart Lung Transport Unit in St Vincent’s Hospital.Credit:Kate Geraghty

“If you’re a family member of a loved one who dies and has been considered as an organ donor it is already such a tough time. But then during COVID-19 there have been limits on visitation… so it is much more challenging to have family consent for organ donation.”

There are currently 69 Australians waiting for a heart transplant with around 1800 Australians on the organ waitlist as of the end of September 2021.

Last year, there was a 16 per cent drop nationally in organ donors and 12 per cent decrease in the number of people receiving a transplant compared to 2019. A total of 1270 Australian lives were saved through an organ transplant in 2020, from 463 deceased organ donors and their families.

“We’ve got some living donors lined up that we have been holding back on until there was less COVID-19 in the community and less risk for them,” Professor Chadban said. “So there’s going to be a build up of people like that and a build up of people on waiting lists.

“But there is guarded optimism about 2022. In terms of transplant numbers, we are way ahead of where we were ten years ago.”

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