Organ transplants have been a bright spot during the pandemic with a gradual increase in overall number of transplants: Transplant Surgeon

Dr. Matt Cooper, MedStar Georgetown Transplant Institute (MGTI), Director of Kidney and Pancreas Transplantation joins the On the Move panel to discuss the impact of COVID-19 on the transplant industry.

Video Transcript

AKIKO FUJITA: The coronavirus pandemic has led to record losses for hospitals across the country, but organ transplants have been a rare bright spot. The US organ donor transplant system has facilitated about 600 more organ transplants compared to the same time last year, at least according to numbers out from the United Network for Organ Sharing. Let's bring in Dr. Matt Cooper. He is a professor of surgery at Georgetown University school of medicine and the Director of Kidney and Pancreas Transplantation at MedStar Georgetown Transplant Institute. A very long title there. But Dr. Cooper, it's great to have you on today.

Let's talk about where things have been since the pandemic. We all know in the initial days, all non-elective surgeries were immediately canceled, leading to a lot of those significant losses we've seen from the hospitals. Organ transplants did continue. How much of an uptick have you seen on that front? And what do you attribute that to?

MATT COOPER: Yes, first, thanks for having me and putting some light on the success of donation and transplants. Like you said, COVID certainly has a lot of negative things that we're going to unfortunately remember 2020 for, but in our field of transplant, there has been remarkable success. Yes, there was an appreciable decline in donations and transplants around the peak of the surge, certainly in the Northeast. But we've gradually demonstrated an increase in the overall numbers of transplants.

Transplants never stopped. Important to appreciate that perhaps there was a need to reallocate where organs could safely be transplanted outside of particular hotspots. But as you mentioned, throughout the course of this pandemic, if you were to compare year over year, we're really proud that we've done over 600 more transplants this time in 2020 than compared to last year 2019. So that's a, I think, a remarkable indication of how the collaboration between donor families, donor hospitals, organ procurement organizations, and transplant centers have all figured out a ways to work together to make sure that the gift of life was not lost.

INES FERRE: Dr. Cooper, Ines here, and despite that, dad there's been a proposed rule change for some of the federally designated nonprofits. Can you expand a little bit about that rule change and what that would entail, what that would mean?

MATT COOPER: Yeah, thanks, Ines. So that there is always an interest in trying to figure out how we can increase the numbers of donors and transplants. Because until we have the, I think the dream of one organ for one patient for one lifetime, we have to always recognize that there's supply and demand problem. And so currently, the CMS rule that's out currently for discussion and for review, is looking specifically at one singular component of a very complex system, which is the organ procurement organizations, which are that vehicle that works sort of as the bridge between donor families and transplant centers.

And what it is looked to do is really to bring up all OPOs to try and increase the number as potential donors. But what it unfortunately fails to recognize, is that it's a very complex system that can't simply be in itself thought if fixed, would solve the entire problem. And so with the current metric is looking to do, is to change the way in which organ procurement organizations are evaluated and trying to determine in fact, how many potential donors across the United States could compare one OPO versus another.

And it's looking at data which is neither complete, nor sensitive, nor specific, utilizing death certificate data to try and determine whether or not potential donors were lost. Unfortunately, the way that it's currently put out there, procurement organizations would have to reach a particular number of donors based upon how many were available. And there's a sort of doomsday scenario, where almost 75% of OPOs could be decertified, and we would all be left to figure out how those organ donations and transplants could happen.

And we're all very concerned. I, as a transplant surgeon, recognize that it's much more than just OPOs looking to try and procure organs. It requires a collaborative effort with transplant centers, assuring that those organs that are procured from deceased donors are actually transplanted. So we're all very interested in doing better. But we have to recognize, the US donation and transplant system is one of the most successful in the world. We don't want to dismantle it by only appreciating one small piece. It requires a much more global approach.

DAN HOWLEY: Dr. Cooper, has the COVID pandemic kind of hurt the amount of people that can donate organs? You're saying that there's an increase in organ donations. Obviously, that means there's gotta be more people able to donate. What has COVID done as a result of that? Has it made more people available to donate? How does that work?

MATT COOPER: Yes, it's a little bit of both, Dan. Thank you for the question. And certainly, some of the shelter in place has resulted in decreased traffic death accidents, which were often a source of potential donors. We have, as a group, must be much more sort of cautious about the potential COVID risks of a donor that may have expired from COVID. Of course, that eliminates as a potential donor.

But again, we've gotten, I think, better and better. We, the transplant community, have gotten better and better at assuring that no potential donor is lost. And so, ideas of our OPO, organ procurement organizations having greater access to hospitals through potentially automated donor referrals to help identify donors more quickly, that process is beginning to take shape.

And we're identifying more donors because of really again, the aggressiveness of our OPO community, of the aggressiveness of transplant centers wanting to make sure that no organ is lost. But again, we've worked very hard as an organization, as a group, to make sure that organs where donated, perhaps unable to be transported locally, found their way to get to somewhere in the United States so they were not wasted. So the numbers of donors has resumed to its pre-COVID numbers. But a lot of that has only been the result of people that are very passionate and making sure that no potential donor and no organ transplant is lost.

AKIKO FUJITA: Dr. Matt Cooper, appreciate you shedding light on this issue. The doctor joining us from MedStar Georgetown Transplant Institute.