Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany.
The Medical Director's Staff Division of Organ Donation Coordination, University Hospital Düsseldorf, Düsseldorf, Germany.
Front Public Health. 2024 Feb 20;12:1356285. doi: 10.3389/fpubh.2024.1356285. eCollection 2024.
The COVID-19 pandemic had a negative impact on the number of solid organ transplantations. After a global decline of 16% in 2020, their numbers subsequently returned to pre-pandemic levels. In contrast, numbers in Germany remained almost constant in 2020 and 2021 but fell by 6.9% in 2022. The reasons for this divergent development are unknown.
The number of deceased with a severe brain damage, potential and utilized donors after braindeath and the intensive care unit treatment capacity were retrospectively compared for the years 2022 and 2021 at five university hospitals in North Rhine-Westphalia, Germany. Reasons for a donation not utilized were reviewed. To enable a comparison of the results with the whole of Germany and the pre-pandemic period, numbers of potential and utilized donors were extracted from official organ donation activity reports of all harvesting hospitals in Germany for the years 2019-2022.
The numbers of deceased with a severe brain damage (-10%), potential (-9%), and utilized donors after braindeath (-44%), and intensive care unit treatment capacities (-7.2%) were significantly lower in 2022 than 2021. A COVID-19 infection was a rarer (-79%), but donor instability (+44%) a more frequent reason against donation in 2022, whereas preserved brain stem reflexes remained the most frequent reason in both years (54%). Overall numbers of potential and utilized donations in Germany were lower in 2022 than in the pre-pandemic period, but this was mainly due to lower numbers in hospitals of lower care. The number of potential donors in all university hospitals were higher in 2022 but utilized donations still lower than in 2019.
The decrease in potential and utilized donations was a result of reduced intensive care unit treatment capacities and a lower conversion rate at the five university hospitals. A COVID-19 infection did not play a role in 2022. These results indicate that ICU treatment capacities must be restored to increase donations. The lower number of potential donors and the even lower conversion rate in 2022 throughout Germany show that restructuring the organ procurement process in Germany needs to be discussed to increase the number of donations.
COVID-19 大流行对实体器官移植数量产生了负面影响。2020 年全球下降 16%后，其数量随后恢复到大流行前的水平。相比之下，德国的数量在 2020 年和 2021 年几乎保持不变，但在 2022 年下降了 6.9%。这种不同发展的原因尚不清楚。
在德国北莱茵-威斯特法伦州的五所大学医院，回顾性比较了 2022 年和 2021 年严重脑损伤、潜在和利用脑死亡后供体以及重症监护治疗能力的死亡人数。审查了未利用的捐赠原因。为了能够将结果与德国全国和大流行前时期进行比较，从德国所有采集医院的器官捐赠活动报告中提取了 2019-2022 年潜在和利用供体的数量。
2022 年严重脑损伤（-10%）、潜在（-9%）和利用脑死亡后供体（-44%）以及重症监护治疗能力（-7.2%）的死亡人数明显低于 2021 年。COVID-19 感染的比例较低（-79%），但 2022 年捐赠不稳定的比例较高（+44%），而在这两年中，保存的脑干反射仍然是最常见的原因（54%）。德国 2022 年潜在和利用捐赠的数量均低于大流行前，但这主要是由于较低护理水平的医院数量较少。所有大学医院的潜在供体数量在 2022 年较高，但利用捐赠仍低于 2019 年。
潜在和利用供体数量的减少是五所大学医院重症监护治疗能力下降和转化率降低的结果。2022 年 COVID-19 感染并未发挥作用。这些结果表明，必须恢复重症监护治疗能力以增加捐赠。2022 年德国潜在供体数量减少，转化率甚至更低，表明需要讨论德国器官采购流程的重组，以增加捐赠数量。
