A record 548 patients got organ transplants at UW Hospital last year, including a record 315 people who received kidneys, even though the COVID-19 pandemic led doctors to shut down elements of the transplant program for parts of the year.
A major reason for the high volume: The hospital, one of the nation’s largest transplant centers, had 173 deceased organ donors, up from the previous record of 150 in 2016. Several organs can be transplanted from most donors.
The number of potential donors increased because more people died from drug overdoses and there was an uptick in heart attacks, strokes and other events that can cause brain death, said Mike Anderson, executive director of UW Organ and Tissue Donation. The uptick likely stemmed from people with chronic diseases putting off medical care due to the coronavirus, he said.
“It’s not something we expected,” Anderson said.
The state’s 4,859 deaths last year from COVID-19 were not a factor in the larger organ donor pool, as a positive test at death rules out donation.
The increase in deceased donors made up for a decrease in living donors, which in recent years have accounted for a growing proportion of kidney transplants, said Dr. Dixon Kaufman, chairman of UW Health’s transplant division.
The hospital closed its living donor program for about two months in the spring when COVID-19 initially struck, and part of the program was shut down again in November and December when coronavirus hospitalizations surged, Kaufman said.
Pancreas transplants were stopped at the same times, as they were considered less urgent than kidney, heart, lung and liver transplants, Kaufman said.
Despite those moves, the number of patients who received any kind of organ transplant surpassed the previous record of 541 in 2005, and those getting kidney transplants exceeded the prior high of 313 in 2016.
“One of the silver linings (of 2020) is how strong the program actually did considering the challenges that were in front of us and for our patients and their families,” Kaufman said.The hospital also had a record of five combined heart and kidney transplants, which many centers don’t do, he said.
UW also did seven heart transplants from donors through circulatory death — the irreversible cessation of heart and lung function — instead of brain death, in a clinical trial of a new process doctors say could increase heart transplants by a third.
The hospital had a sharp decline in a special type of living organ donor — a non-directed donor, who gives a kidney to a stranger without having a loved one or friend needing one in return. After a record 28 non-directed donors at UW in 2019, the hospital had six last year before COVID-19 restrictions halted the program in March, Kaufman said.
Four transplant recipients contracted COVID-19, Kaufman said, including two who apparently were infected at home after being discharged and were readmitted, and two who apparently got it during long stays at the hospital. All four are now doing fine, and the cases led to more frequent testing of patients and staff, he said.
The pandemic also created challenges for those who handle organ donors. Doctors and others who fly in small airplanes to retrieve organs at hospitals around the state had to be quickly outfitted with protective equipment, said Dr. Nikole Neidlinger, associate medical director of UW Organ and Tissue Donation.
Sensitive conservations with loved ones to confirm consent for organ donation had to be done by Zoom or with medical staff wearing masks and face shields, Neidlinger said.
“Neither are ideal,” she said. “But our team was able to overcome it, and the families in Wisconsin are really generous.”
Even though active COVID-19 rules out organ donation, UW Hospital did have one donor who recovered from a coronavirus infection, tested negative and died from another cause, Neidlinger said. Doctors at UW and two other centers published their experiences, in the journal Transplant Infectious Disease, with six such donors from whom 13 organs were transplanted with no COVID-19 transmission.
Anderson said 68% of last year’s organ donors at UW had registered through the state Division of Motor Vehicles or at donatelifewisconsin.org. Doing so makes the process much easier, he said.