To think that the knock-on effect on organ transplants is going to be huge or possibly even irrecoverable?

[AlternativePerspective]

I will start by saying that I need a heart transplant, although I am currently well enough to not need to be on the list. But while transplant is something we often talk about on here,I think that many haven’t considered what the effects of CV are going to have on transplants both now and in the future.

Currently all transplants have been stopped because A, it cannot be guaranteed that any donor would be CV free, and B, because removing someone’s immunity at this point in order to prevent rejection is far too risky.

There is currently already a shortage of organs which means that many people die on the list before a donor is found, but this pandemic means that there are currently no organs and no transplants, meaning that the numbers of people who are going to die are going to be hugely increased.

Added to which, the numbers of people who will end up reading transplants, possibly even because of the effects of CV is also going to increase, but with no current hope of a transplant being possible in the near future.

They’re currently talking about shielding the most vulnerable until a vaccine is found, this potentially means that transplants won’t be being carried out for the foreseeable future.

I can’t help wondering if this is ever going to be recoverable, or whether the science which has already been working on such things, should consider more the possibilities of other ways to effect a transplant in those who need one, possibly without the need for donors.

I had not specifically thought of transplants, but have been hinting of several other procedures which are at best delayed, due to Covid 19.
From what I read recently, and I am sorry, I cannot remember the source, but the surgeon concerned did say that transplants would be considered at the moment, as a treatment of last resort, as it were.
I take that to mean that patients may well have deteriorated further than would normally be the case before surgery.
I think the same may apply to other immunology treatments, including donated bone marrow transplants etc.
Currently watching the Commons Health Committee Q&a which is interesting if not specific to your concern.
Sorry, I am waffling, but I hear your concern, and share it. Wish you well OP.

There definitely will be a delay but I believe that some transplants are still taking place when it's urgent and the hospital still has capacity to do it. I am currently waiting to have a kidney transplant - luckily I have a live donor and that has been put back. I am not expecting it to take place for the next year now, but luckily I am pretty well. I did however seen on a Facebook group I am a member of that someone did get a deceased donor kidney a couple of days ago so some are definitely still happening (it surprised everyone on the group as we all thought the list was suspended).

It's horrible for anybody who needs a transplant. But I'm sure you understand that what they are doing is reasonable, as to perform surgery right now would pretty much ensure that every transplant candidate would die. Yes, they are dying anyway, as they are on the list for that reason, but not necessarily this week or month.

A long time ago, transplants were halted because the recipients weren't surviving and were effectively suffering more than had they been supported and made as comfortable as possible for their last days/weeks/months. No doctor is going to want to remove somebody's heart in the knowledge that they have done something that will kill them in the next couple of weeks - they do it because there is a good chance that their patient will survive and live a far longer and healthier life. And then, once the issues resulting in those deaths were addressed, transplants resumed.

It's a pause that is genuinely terrible for those who will die in the period from now until resumption. But afterwards, the new presumed consent, the additional experience in dealing with a new disease, the increased number of ventilators and other equipment and the increased experience they will have in dealing with such things as GVH because they can't go for a second, will mean that those who get through this time with their illnesses and those who become ill will still have their chance - if not more of one than before.

(Context - a friend's child is a multiple transplant long term survivor and we chose to consent to donate when my brother was in an accident literally a year ago. She was the one person who kept in touch with me over that last night, explaining what would happen and keeping me company as I sat at his bedside, waiting for his time in theatre. I hope that everybody who received my brother's organs and whatever else they could use, such as corneas, is safe and well).

@ MitziK oh I totally understand why this has to happen. I suppose I was just musing about it really and thinking that maybe this will lead to changes in things going forward i.e. there are already lots of trials under way talking about alternatives to transplants where donors are required, and wonder if those might be considered more viable in the future.

You aren’t wrong.

I somehow hadn’t even thought about this. Probably just in denial because it’s so obvious and so very terrifying.

We had a scare with DH’s transplanted kidney recently. He is 20 years in at this point so needing a replacement eventually is likely.

It shouldn't matter if a donor is CV free, because they are still taking and using blood donations, and the NBS say that there's no evidence of it being bloodborne.

And it's not inherently more risky to immunosuppress someone in preparation for the surgery than it is for people who have already had transplants, and are immunosuppressed long-term. Especially as they are keeping CV patients separate from other cases.

So I think saying they're almost certain to die is overblowing it rather. As usual, each case should be judged on its relative risks.

But yes, it would make far more sense (in any situation) to prioritise growing new organs for patients from their own stem cells.

I’m sure it’s far less about the risk to the transplantee and far more about the fact that the NHS simply does not have the capacity to be conducting organ transplants right now.

I also imagine, even if transplants were being carried out, surely far fewer organs would become available during the lockdown period anyway? There must be way less road traffic accidents at the moment.

I have been pondering this as well lately. A colleague is an organ recipient and I know of someone requiring multiple transplants.

It is the whole process that poses risks - lack of ICU beds, staffing issues, and then the risks once an organ is transplanted. I'm not sure when a right time to start again would be.