In a document released this Monday (6/3), the Brazilian Association of Organ Transplantation (ABTO) shows that the country only performed half of the necessary procedures during 2022. The Brazilian Transplantation Report points out that around 40,000 corneal transplants were needed , liver, heart, lung and kidney, but only 21,800 procedures were performed.
ABTO’s expectation was that, with the control of the Covid-19 pandemic, the number of donors and procedures would return to the levels verified before the pandemic, but that was not what happened.
“The recovery of donation and transplant rates in the post-COVID-19 pandemic is very slow and we have not been able to return to the levels obtained in 2019, suggesting that there are other factors, in addition to the pandemic, making it difficult to resume transplants”, writes Valter Duro Garcia, one of the association’s founders, in an editorial published with the report.
The survey shows that, although the rate of possible donors is growing in some states, the effectiveness of the donation remains very low and, today, is 20% lower than it was in 2019. According to ABTO, this drop is related to the increase in family non-authorization rates and medical contraindications.
“The family denial rate (47%) was 18% higher than the 2019 rate (40%) and the highest in the last ten years. The medical contraindication rate, which was 15% in 2019, reached 23% at the height of the pandemic in 2021 and ended the year at 17%, 13% above that obtained in 2019”, says Garcia.
Corneal transplant was the hardest hit by the pandemic
According to the report, corneal transplantation was the hardest hit by the Covid-19 pandemic. Although the number of procedures has been increasing since 2021, the rate is still below what it was in 2019. Before the pandemic, there were 71.3 transplants per million population — today, the number has dropped to 65.5, far from the goal of 90.
Ophthalmologist Ricardo Filipo, from the COI Integrated Ophthalmology Clinic, in Rio de Janeiro, explains that the drop in the number of procedures is largely due to the lack of donors. “The great challenge for us to change this reality of the corneas is the awareness of the families of potential donors”, he says.
The main problems that may trigger the need for a transplant are keratoconus, corneal dystrophies, bullous ceropathy, severe corneal infections, leukomas and corneal perforations.
“The patient can suffer losses in quality of life, such as in social and day-to-day activities, and also at work, and can often be forced into disability retirement”, says the doctor. Without the transplant, the individual may have permanent blindness.
waiting patients
The ABTO document shows that there was an increase in the number of people waiting for a heart transplant (23%) and lung (21%), kidney (18%), liver (9%), compared to 2019. The queue of patients waiting for a pancreas transplant, in contrast, decreased by 13%.
“Surprisingly, there was a decrease in waiting lists for kidney transplants (18%), liver (21%), heart (23%), lung (34%) and pancreas (20%). Therefore, the increase in the number of patients on the waiting list must have been caused by the drop in the number of transplants”, points out the report.
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