Consequences of the COVID-19 Pandemic on Worldwide Organ Procurement and Transplantation

The COVID-19 pandemic has created an unprecedented burden on healthcare systems worldwide. For many healthcare domains in different nations, there are currently no structured data registries, making the pandemic-related impact difficult to capture.

Organ transplantation is well-regulated, with a specific nationwide day-to-day reporting scheme, offering a unique opportunity to illustrate the impact of the pandemic on healthcare systems. Reductions in the number of transplants compared to the previous year can reveal the consequences as countries adjusted to the pandemic.

Transplant data from centers around the world were compiled to assess the impact of the COVID-19 pandemic on organ donation and transplantation and consequences for waitlisted patients. Data were collected from the beginning of the COVID-19 outbreak on January 1st 2020 up until January 1st 2021, along with data from the same period in 2019.

Details can be found in our peer-reviewed publication:

 COVID-19 pandemic and worldwide organ transplantation: a population-based study

The study is registered with clinicaltrials.gov (NCT04416256)

Country Data source Date of 100th COVID-19 case
Argentina Instituto Nacional Central Único Coordinador de Ablación e Implante March 20 2020
Austria Eurotransplant March 8 2020
Belgium Eurotransplant March 6 2020
Brazil Brazilian Organ Transplant Association March 13 2020
Canada Organ & Tissue Donation and Transplantation March 11 2020
Chile Corporación Nacional de Trasplantes de Chile March 15 2020
Croatia Donor Network of Croatia Eurotransplant March 19 2020
Finland Helsinki University Hospital March 13 2020
France Agence de la Biomédecine February 29 2020
Germany Deutsche stiftung organ transplantation/Eurotransplant March 1 2020
Greece Hellenic National Transplant Organization March 13 2020
Hungary Eurotransplant March 21 2020
Ireland Eurotransplant March 14 2020
Italy Centro Nazionale per i Trapianti February 23 2020
Japan Japanese Organt Transplant Network February 21 2020
Kuwait Asian Society of Transplantation March 14 2020
Malaysia Asian Society of Transplantation March 9 2020
Myanmar Asian Society of Transplantation NA
Netherlands Eurotransplant March 6 2020
Norway Scandiatransplant March 6 2020
Paraguay Paraguayan Society of Transplants April 5 2020
Portugal Instituto português de sangue e da transplantação March 13 2020
Slovenia Eurotransplant March 13 2020
Spain Organización Nacional de Trasplantes March 2 2020
Sweden Scandiatransplant NA
Switzerland Swiss National Foundation for Organ Donation and Transplantation March 5 2020
United Kingdom National Health Service March 2 2020
United States United Network for Organ Sharing/Organ Procurement and Transplantation Network March 4 2020

Transplant totals include solid organs: kidney, liver, lung, and heart. Dual transplants are counted for each separate organ.

Line graphs:

COVID-19 cases and total transplants over time (2019, 2020, or ratio of 2020/2019), starting from the date of the 100th recorded COVID-19 case for each country until the end of the follow-up date. All transplant data were smoothed in two steps: first, by calculating a 14-day moving average; second, by applying locally estimated scatterplot smoothing (LOESS) to the moving average.

Bubble charts (3D scatter plots):

x-axis: COVID-19 deaths per million inhabitants calculated from data retrieved from the Johns Hopkins University COVID-19 Data Repository and the World Bank.

y-axis: percent diminution of transplant rate in 2020 compared to the same period of time in 2019.

Bubble size reflects the number of deceased donor transplants in 2019 according to the Global Observatory on Donation and Transplantation (GODT).

Geographic heatmaps (choropleth maps):

Transplant totals in 2019 and 2020 and total COVID-19 cases by region for each country with available data.

Transplant totals are from the date of the 100th confirmed COVID-19 case through the end of April 2020 and the same period of time in 2019.

Heatmap gradients for COVID-19 cases and transplants in 2019 and 2020 were determined using the Jenks natural breaks classification method.

Disparities in COVID-19 related data collection and reporting are well-known and the definition of cases has been updated by each country since the onset of the pandemic with discrepancies in testing accuracy and reporting. No universal and consistent measure for COVID-19 cases exists, but these are measures that cannot be truly ascertained.

The Johns Hopkins database is one of 3 key sources providing regular updates of global COVID-19 cases and deaths, in addition to the WHO and the European Centre for Disease Prevention and Control. Overall, the trends are highly similar among these data sources. Johns Hopkins numbers are higher than those reported by the WHO and the European Centre for Disease Prevention and Control, which may be due to the inclusion of ‘presumptive positive cases’, those confirmed by local but not national laboratories.

Data discrepancies may arise. Corrected datasets will be updated accordingly.