Coronavirus complicates organ transplants as donations drop locally and nationally

Hailey Steimel hasn't left her Cedar Rapids neighborhood since mid-March, relegated mostly to taking walks to get outside every day.

A heart-transplant recipient, the 23-year-old's world has shrunk considerably as she's tried to stay healthy but avoid the spread of the novel coronavirus.

'It's been hard at times because I miss seeing my friends and doing normal things,” she said.

Around the time Steimel stopped being able to get out more freely, organ transplants began happening with less frequency both nationally and locally.

The North Midwest region, of which Iowa is a part, saw a brief lull in deceased donor transplants before picking up again. But living donor transplants stopped almost completely until near the end of April.

As of Tuesday, there have been 1,455 total organ transplants in the region, compared with 1,646 transplants by this time in 2019 - almost as 12 percent decline.

Between January and May, 27 deceased Iowans have donated a total of 76 organs. That's down nine donors from the same period in record-breaking 2019. However, this decline can't be traced to the COVID-19 pandemic with confidence, Iowa Donor Network Director of Strategic Communications Heather Butterfield said. As of June 3, no patients recommended to the donor network for possible organ donation have been ruled out due to having had the virus.

'We have not ruled out any potential organ donors due to COVID-19,” Butterfield said.

According to the Association of Organ Procurement Organizations, living donors who test positive for COVID-19 are not eligible to donate until they test negative again. And organs cannot be harvested from deceased donors who die as a result of the virus.

Dr. Alan Reed, director of the University of Iowa Hospitals and Clinics Transplant Center, said a lack of tests and intensive care beds in hospitals led to the number of donors dropping, which affected the whole transplant community.

Reed said the transplant center wouldn't have accepted any organs that weren't tested for the coronavirus.

The center was able to continue to do some transplants due to the hospital system preparing for a large number of COVID-19 patients. Before every transplant, teams had to make sure they had all the personal protective equipment and other resources needed, including tests to check the patient.

Now UIHC has resumed elective surgeries, including living donor transplants.

What comes after the transplant can pose just as much of a risk to patients as it does before the donation. Reed said transplant recipients are medically immunocompromised. So those transplant patients have an increased risk of contracting the virus and have to be more cautious than most. Depending on how recent their transplant was, they may have to go in for checkups and other medical appointments.

Telemedicine has certainly improved during this time, Reed said, but it can't allow a doctor to draw blood or physically examine a patient.

People have also been worried about going to the doctor's office, which could lead to them not going in when they should, Reed said.

Steimel received her heart in February 2014 when she was 17 after being on the waitlist for about three months. She's had to visit her doctor twice since the pandemic began to get labs drawn, and will visit UIHC for her biannual appointment in August.

'I'm a little scared about that, but I'm sure they'll be prepared when I go,” she said.

If the pandemic continues and worsens, Reed said the number of donors will decrease again, the transplant waitlist will grow longer, and people may die waiting.

Steimel said she knows people currently waiting for transplants, and she's worried about them and the waitlist growing longer. As of June 1, there are 624 Iowans waiting for transplants, and 111,213 in the United States.

'It already takes so long to get a transplant,” Steimel said. 'It's just scary to think about.”

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