The Coronavirus Process Negatively Affected Organ Donation

Speaking for World Organ Donation Week (3-9 November), Hayata Bağış Derneği Chairman Hüseyin Yıldırımoğlu underscored the negative impact that coronavirus has had on the organ donation process. Hüseyin Yıldırımoğlu noted that due to the pandemic, the allocation of some intensive care beds to coronavirus patients, and the requirement for two negative test results to prove that brain-dead donors and those whose families authorized organ donation do not carry coronavirus, has caused donations to decline. Hayata Bağış Derneği Chairman Hüseyin Yıldırımoğlu, Koç University Hospital Organ Transplant Coordinator Mümin Uzunalan and Koç University Hospital Kidney and Pancreas Transplant Center Director Prof. Dr. Burak Koçak spoke on the occasion of World Organ Donation Week on 3-9 November. Highlighting that statistically approximately 30 patients waiting for organs on the lists are lost each day, Hüseyin Yıldırımoğlu stated, "We have approximately 27,000 patients waiting for organs, but we are uncomfortable with how easily the figures are cited. We believe that looking at waiting patients in terms of cases or numbers is simplistic and does not encompass the message we wish to convey.

What we are trying to convey is that each of these figures has separate stories, families, friends, professions—in short, that each is human and while a life's worth cannot be measured, each one multiplies into thousands. When we look at it this way, we see and know that an entire family, a house, an apartment building, a street, a neighborhood, or even a city full of people is waiting for organs," he said.

Speaking on the pandemic's impact on organ donation, Hüseyin Yıldırımoğlu said: "Cadaveric organ transplantation, the allocation of some intensive care beds to coronavirus patients due to the virus, and the requirement for two negative test results to prove that brain-dead donors and those whose families authorized organ donation do not carry coronavirus have led to decreases in organ utilization rates and organ donations. During the pandemic period, as with every business sector, the health sector had to adapt to changing variables."

Noting that those lacking information have provided misleading guidance on organ donation, Hüseyin Yıldırımoğlu spoke as follows: "To prevent this, we need to communicate the facts about organ donation and transplantation more transparently to our people. Survey studies on organ donation have found that due to people's concerns about the health system, they worry that should they suffer a sudden accident or trauma and an organ donor card emerges from their pocket, they would be quickly abandoned. With this logic, every patient in an intensive care bed appears as a potential organ donor. We constantly try to explain brain death, that brain death is true death, that there is no return, and that organ distribution is done justly and transparently by the Ministry of Health. Organs are not objects we can purchase from somewhere; their sole source is human beings, and the belief that the donated organ will go to the right place and the relief of worries can only come through education and information. In every event we organize as an association, our goal is to reach one person. If we can change one individual's perspective positively, it will be our greatest spiritual satisfaction, as it has been until now and will continue to be."

Relatives must necessarily approve organ donation

Stating that organ donation is not possible from every deceased person, Mümin Uzunalan said, "For cadaveric organ donation, death must occur under intensive care conditions, with the patient connected to mechanical ventilation. The relatives of the deceased must also consent to organ donation. Whether a person authorizes organ donation during their lifetime or not, according to our country's legislation, approval from surviving relatives is absolutely required." Noting that it is very difficult to give a specific timeframe regarding waiting periods for organ transplant patients, Mümin Uzunalan explained: "Patients with living donors are able to receive organ transplants in a short time. However, organs that can be transplanted from living donors are only the liver and kidney. The waiting period remains uncertain for patients without living donors as well as those suffering from heart, lung, pancreas, and small intestine failure." The waiting period for organ transplant is a very difficult process for both patients and their families Emphasizing that the waiting period is a very difficult process for patients and their families, Koç University Hospital Kidney and Pancreas Transplant Center Director Prof. Dr. Burak Koçak stated: "Donors should not be reluctant about transplantation. Because timely completion of transplants can prevent greater health problems for patients. These measures enable transplants to be performed. Our patients should not hesitate about organ transplantation at this point. On the other hand, unfortunately, cadaveric organ donation numbers in our country are very low. In recent years there have been small increases, but compared to expectations, there are serious gaps. As a result, patients' waiting periods lengthen, their diseases progress, and this situation begins to damage their other organs.

Patients are sometimes forced to be hospitalized for treatment, and the number of such hospitalizations and the severity of each hospitalization is increasing. Chronic organ failure is a very painful process for patients' families. Depending on disease stages, family life is negatively affected by loss of work capacity, absence from education, developmental delay in children, psychological breakdown, social isolation, and dependence on hospital-based living," he said.

Opening a separate parenthesis on the decline in organ donations during the coronavirus period, Prof. Dr. Burak Koçak noted: "The pandemic period particularly had a negative impact on cadaveric organ donations. Several reasons can be cited, such as the gradually increasing occupancy rates of intensive care beds, the inevitable coronavirus screening that must be performed on donors prolonging the process, and difficulties in informing families about the procedure.

However, the same situation cannot be said for living organ donors. Donors motivated by the desire to restore their loved ones to health present themselves with strong motivation. We must ensure that they are healthy individuals and that the planned surgery, during the operation, and for the rest of their life will not harm their health. For this purpose, many tests and evaluations are performed in accordance with modern medical practices. As in the rest of the world, additional measures brought about by the pandemic conditions that have caused us difficult times in our country are, of course, being applied strictly," he said.