Second year of the pandemic – fewer organ transplants in 2021 in Austria

Due to the effects of the Covid-19 pandemic, the number of kidney transplants has dropped significantly for the second consecutive year. While in 2018 there were always over 400 of them and 386 in 2019, there were 335 in the first year of the pandemic and only 306 in the previous year. In return, the frequency of lung transplants has increased significantly. While 100 such interventions were performed in 2019 and 2020, a total of 123 lung transplants were performed in 2021. The second most frequently transplanted organ was the liver with 159 operations, 158 in 2020 and 151 in 2019 in total. The number of heart transplants remained exactly the same as in 2020 – 59, compared to 67 in 2019. There were 14 pancreatic transplants last year, up from 20 in 2020.

In 2021, 270 deceased people were reported as potential organ donors in Austria, and 168 of them had had an organ transplant. For comparison, the year before, there were 308 potential donors and 188 actual organ donors. On a regional scale, the largest number of donors was in Vorarlberg (35.1 per million inhabitants), followed by Salzburg with 33.9. Carinthia and Styria with 24.9 donors. The majority of living donors are female (55 percent), and the majority of organ donors in brain death (60 percent) are male. Most of the organ donors were between 45 and 59 years of age (40 percent).

As in 2020, high bed occupancy in intensive care units with Covid-19 patients and the heavy burden on intensive care personnel as a result of the pandemic had a negative impact on organ donation in 2021. While in 2020 only a few federal states recorded a decrease in the number of donors and organ donation, but overall it was possible to maintain the level of previous years, the number of organ donations across Austria in 2021 will be lower than in the previous year. year. Across Austria, it was now 168 organ donors in absolute numbers, or 18.8 per million inhabitants, while in 2020 still 188 or 21.1 were registered. This corresponds to a decrease of approximately eleven percent. In the years preceding the pandemic, there were always well over 20 organ donors per million inhabitants, in 2014 it was 24.3. In the report, special attention is paid to the intensive care unit services, which, despite the tense situation, recognize potential organ donors and take all necessary steps to enable patients on the waiting lists for transplantation.

Even though the numbers have dropped, Austria is still in the lead in the international comparison when it comes to the number of donations and transplants. There is an objection law in this country – organs may be harvested from people after brain death, if there is no documented objection to this. This regulation is already 40 years old – the act entered into force in 1982. On the other hand, the opposition register has only been in existence since 1995. When it comes to lung transplantation, Austria ranks by far first in the international comparison – data are available for 2020. Compared to the comparator countries, there were 11.2 lung transplants per million inhabitants. In 2021, a total of 2,960 people were entered into the register of objections to donation, and 208 people were removed from it. The total number of registered actively opposers at the end of 2021 – minus removals and deaths – is 55 972 people in Austria.

The number of people on the waiting lists has increased significantly. At the end of 2021, 829 patients were on the waiting lists for an organ, ten percent more than in 2020. At the end of 2021, 635 were waiting for the kidney, 91 for the liver, 45 for the heart, 47 for the lung, and 11 needed a pancreas donation. The waiting time to identify the appropriate donor organ varies from organ to organ. While the median waiting time for the kidney is 36.2 months (from first dialysis), the waiting times for the heart (median 2.3 months), lungs (median 3.7 months) and liver (median 1.7 months) are longer than year. The median is the average length of stay on the waiting list in months until transplant or death between January 1, 2016 and December 31, 2021.

The report also covers stem cell transplants in 2021. In 2021, over 110,000 stem cell donors were registered in the Austrian stem cell registry. Thanks to an international network of cooperation with other registries, there are currently almost 40 million donors of stem cells available worldwide, and in 2020 89% of stem cell donors. external donor was identified in patients. The average search time until a suitable unrelated donor was identified was 25 days (median) in 2021. The number of withdrawals from Austrian donors increased significantly from 43 in 2020 to 48 in the previous year.

In 2021, a total of 656 stem cell transplants were performed in Austria. The number of allogeneic stem cell transplants – here the donor and recipient are not identical – increased significantly in 2021 by 279 stem cell transplants compared to 2020 from 239. The increase in the number of adults was 241 in 2021 compared to 206 in 2020 and there was a slight increase increase in the number of children to 38 in 2021 compared to 33 in 2020. The number of autologous transplants – here are identical donors and recipients – also increased: 377 in 2021 compared to 352 in 2020.

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