Brain Death and Organ Donation During the COVID-19 Pandemic: A Retrospective Observational Study

Abstract

Aim: Transplantation processes were impacted worldwide due to the COVID-19 pandemic. The present study investigates brain death and cadaveric organ donation during the pandemic at a large referral hospital in Turkey. Methods: All brain death cases diagnosed between 11.3.2020 and 11.3.2021 in our center were retrospectively evaluated. Patient data were analyzed, including demographic characteristics, family consent rates, and additional COVID-19 tests for donor eligibility. In addition, declaration and donation times, the number of donors, and the usability of organs were studied. Furthermore, the patients whose organs could not be used despite family consent were considered regarding the medical reasons for that outcome. Results: 26 adult brain death cases were included in the study. Family consents were granted in seven (26.9%) patients. The organs of three of the seven cases with family consent were transplanted. In one of the remaining four, the second RT-PCR test was positive. In the other ones, both RT-PCR tests were negative, but COVID-19 could not be ruled out through laboratory tests and chest tomography, and bactere-mia were evident in blood cultures. The non-donor’s lymphocyte count (0.665 ×109/L [0.340-0.770]) was significantly lower than that of donor (1.182 ×109/L [1.050-1.780]) (p <0.05). Besides, procalcitonin levels were significantly higher among non-donors (10.48 μg/L [3.19-26.68]) (p <0.05). Conclusions: The COVID-19 pandemic has drastically affected trans-plantation processes. Prolonged stays due to additional evaluations for COVID-19 may pose the risk of intensive care acquired infections in donors and should be careful in terms of donor loss due to infections.