As the number of COVID-19 cases in America steadily climbs, more hospitals across the U.S. are temporarily delaying kidney transplant operations.

This news can come as a crushing blow to patients awaiting transplants. If you’re one of those patients, you’re probably wondering what’s driving that decision. An article by the American Kidney Fund’s vice president for patient services and kidney disease education, Mike Spigler, explains why.*

Hospital Overwhelm

While most, if not all, people awaiting a kidney transplant would consider their upcoming surgery to be non-elective, the donor’s side of the transaction is considered elective and non-essential.

Since a living-donor kidney transplant requires two beds and recovery care in a hospital setting, individual hospitals have to consider:

• how widespread and severe the virus cases are in their communities
• how long the prospective transplant patients can remain safely on dialysis
• what the needs might be for their limited numbers of beds, staff, and supplies to treat critically ill COVID-19 patients

Transplant Recipients Especially Vulnerable

The special vulnerability of transplant recipients to the coronavirus is threefold:

1. People on dialysis already have weakened immune systems. Due to the ease and speed of the coronavirus’ spread, hospitals want to keep uninfected people out of facilities where there are large numbers of infected patients.
2. Hospitals now have to test deceased donors for the virus to ensure they are not transplanting an infected organ. In communities rife with coronavirus infections, the limited number of available test kits are being reserved for living patients who can be treated.
3. Immune-suppressing drugs that must be taken daily by transplant recipients following surgery leave them largely defenseless against even the common cold. The novel coronavirus, against which no humans have developed immunity, poses a significant threat. 

Ventilators and Organ Harvesting

Donors who are medically brain dead are usually kept alive on ventilators so their organs can be harvested and transplanted. Since COVID-19 affects the lungs, the need for ventilators to treat infected patients is at an unprecedented high, and the supply devastatingly low.

Next Steps

Nobody was prepared for a health emergency of this scope and intensity. Decisions of the sort that medical leadership now has to make are not made lightly. No one knows exactly when this outbreak will end, but the situation is temporary.

In the meantime, the most important step is to maintain your dialysis treatment schedule and healthy lifestyle, and follow safety protocols concerning the coronavirus. 

The National Kidney Registry provides a list of the top US kidney transplant centers and their current statuses. 

For more information and resources, see the full article by the American Kidney Fund.

*Spigler, M. (2020, March 23). 3 reasons the coronavirus pandemic is affecting kidney transplants [Blog post].