Half of organ transplants were not performed in 2022 – 03/06/2023 – Health

Even with the cooling of the Covid-19 pandemic, organ donation rates remain below what was seen before the health emergency. In 2022 alone, almost half of the five organ transplants were not attended to in Brazil.

The estimate is from the RBT (Brazilian Transplant Report) of 2022. According to the document, more than 40,000 corneal, kidney, liver, heart and lung transplants were needed. However, only about 21,000 organ transplants were actually performed last year.

The drop in the number of donors and donated organs has been seen since the beginning of the Covid-19 pandemic. Gustavo Fernandes Ferreira, president of ABTO (Brazilian Association of Organ Transplants), entity responsible for the report, explains that, before, Brazil had been presenting an increase in the number of donors.

In 2019, there were 18.1 effective donors per million people, a higher rate than in previous years. But the scenario was interrupted by the health emergency caused by Sars-CoV-2. In 2020, the rate dropped to 15.8 and then dropped further in 2021.

It was to be expected that, in 2022, organ donations would return to levels similar to those before the pandemic. But that is not what happened: last year, the country even recorded an increase in the number compared to the previous year, reaching 16.5, but still below the trend observed pre-Covid-19.

The perception makes other factors possibly associated with the slow recovery in the number of transplants. One of the explanations may be related to family refusal, which occurs when the family denies organ donation from the donor.

According to data from 2022, the refusal rate was 47%, the highest in the last ten years. In 2019, before the pandemic, this percentage was 40%. Ferreira says that the rate is worrying because, if there was no denial of family members in 2022, “we could practically double the capacity of donors”.

This increase in refusal leads to a lower rate of making a donation. In 2022, this effectiveness was almost 27%, while, in 2019, approximately 33% was recorded.

Another aspect that is related to the drop in effectiveness are the medical contraindications. The report reports that this rate was 17% in 2022. The percentage represents a drop compared to 2021, when 23% of potential donations went through contraindication. However, the index is still above the 15% that was observed in 2019, before the pandemic.

The president of ABTO explains that these contraindications are made by the donation center when it assesses that the donor is not suitable for the patient in search of the organ. But this caveat can also occur for another reason: when the transplant center does not have the full capacity to perform the transplant.

The point is related to the difficulty that Brazil faces in not only increasing the number of donors, but also improving the capacity to perform transplants. Ferreira cites how this can be problematic with examples from 2022.

“If you observe, the number of donors increased more than the number of transplants. So there is a gap that we need to better understand what is happening and why we managed to recover more from the donation than from the transplant”, he exemplifies.