Johannesburg - South Africa’s official cumulative death rate from Covid-19 hit 45 902 on Friday. Now experts are warning 10 percent more South Africans – adults and children – could perish if they don’t get the vital organ transplants that the pandemic has denied them.
The reasons are two-fold: coronavirus has temporarily halted all transplants, but the donor pool is shrinking too – because of the prohibition of alcohol sales that had been in place until Tuesday this week.
Road accidents are the main source of organs for transplant operations, with alcohol being a contributing factor in 27.1 percent of all fatal crashes in South Africa according to a survey conducted by the Road Traffic Management Corporation, the South African Medical Research Council and the University of South Africa last year.
Neither the director of the Organ Donor Foundation, Samantha Nichols, nor the director of the South African Transplant Society, Dr David Thompson, would be drawn on the link with alcohol.
But In September government appointed Professor Rafique Moosa as the new chairperson of the Ministerial Advisory Committee (MAC) on Organ Transplantation, who said doctors should be referring more potential donors
“If one looks at the total number of motor vehicle accidents [251 deaths per million population], there should be more than enough donors to supply the needs of the country."
South Africa still struggles to find enough organ donors, he said. "The number of transplants has remained relatively static for the past 10 years or so," said Moosa, who is the executive head of the Department of Medicine at Stellenbosch University and Tygerberg Academic Hospital.
"For example, the number of kidney transplants in South Africa vary between just 400 and 450 a year. We have been trying to understand why the number of donors has not increased.“
Thompson said the donor pool has definitely dropped.
“Ideally, we should at least have half of the population as donors.”
South Africa’s population is estimated to have increased to just under 60-million people last year, but the country only has 342 624 registered organ donors.
Each donor can save up to seven lives – and benefit up to 50 patients – through the successful transplanting of hearts, lungs, kidneys, corneas, skin and pancreas.
A healthy adult liver can save two children. Patients needing transplants can wait up to eight years for the right match. Many will die before then. Now the risk for the 4 300 patients currently waiting for transplants has just become that much longer.
Prior to the pandemic, South African hospitals would have performed around 360 transplants per year. Last year that number was halved.
“Many centres decided to not perform transplants at the start of the pandemic in March 2020,” said Nichols. “South Africa is not unique but we are worse-affected,” she said.
The effect of the pandemic goes even further.
“Many people have died of the coronavirus but we cannot use organs where the person had an active infection. However, if you recover from Covid-19, you can still be an organ donor,” Thompson said.
The donor crisis though is worldwide. In the US, deaths from motor vehicle crashes and fatal injuries account for a third of all organ donations according to the United Network for Organ Sharing (Unos) which manages the nation's organ transplant system.
From March 8 to April 11 last year, the number of organ donors who died in traffic collisions was down 23% compared with 2019, while the number of donors who perished in all other accidents was down 21%.
In Britain, the number of organ transplant operations dropped during lockdown, as a fall in violent crime and car accidents reduced the pool of donors. The UK’s National Health Service (NHS) reported that only 265 transplant operations were carried out between April 1 and May 31 last year, compared to 702 carried out in the same period in 2019.
As is the case in SA, most transplant centres across the UK closed at the beginning of the pandemic, with only the most essential operations – such as heart transplants – going ahead in lockdown. Despite the gloom, Nichols said they try to focus on the positives.
“Lifestyle diseases are increasing and the state hospitals do not have the resources needed. So, it’s up to all of us to become registered donors,” she said.
“Many people think it’s a challenge to become a donor but it is really very simple. You just need to talk to your family. I believe every South African should know about organ donations – even those over the age of 70. There are no costs involved,” she said.
If you would like to register to become an organ donor go to www.odf.org.za to find out more.