Transplantation in India and China during the COVID-19 pandemic
Authors: Vivek B Kute, Hari Shankar Meshram, Beatriz Mahillo, Beatriz Dominguez-Gil
Journal: The Lancet Public Health (2022)

Olivier Aubert and colleagues1Aubert O Yoo D Zielinski D et al.COVID-19 pandemic and worldwide organ transplantation: a population-based study.Lancet Public Health. 2021; 6: e709-e719Summary Full Text Full Text PDF PubMed Scopus (15) Google Scholar have done remarkable research on the worldwide impact of the COVID-19 pandemic on transplantation. However, data from India and China were not included in their report. As of Oct 23, 2021, India had the second-most COVID-19 cases worldwide.2WHOWHO Coronavirus (COVID-19) dashboard.https://covid19.who.int/tableDate accessed: October 21, 2021Google Scholar By contrast, China has shown a rapid decline in COVID-19 cases over time. The registered number of COVID-19-related deaths is 453 052 in India versus 5695 in China. India and China hold third and second positions globally in the absolute number of transplantations annually.3Kute VB Ramesh V Rela M On the way to self-sufficiency: improving deceased organ donation in India.Transplantation. 2021; 105: 1625-1630Crossref PubMed Scopus (1) Google Scholar, 4Global Observatory on Donation and TransplantationSummary.http://www.transplant-observatory.org/summary/Date accessed: October 21, 2021Google Scholar Therefore, inclusion of the landscape of the COVID-19 pandemic in both countries would enrich the data presented by Aubert and colleagues.1Aubert O Yoo D Zielinski D et al.COVID-19 pandemic and worldwide organ transplantation: a population-based study.Lancet Public Health. 2021; 6: e709-e719Summary Full Text Full Text PDF PubMed Scopus (15) Google Scholar During 2020, India had a sharper decrease in transplantation rates compared with China (41·2% vs 7·8%; appendix).4Global Observatory on Donation and TransplantationSummary.http://www.transplant-observatory.org/summary/Date accessed: October 21, 2021Google Scholar In both India and China, deceased donation was more affected compared with live donation. In India, the decline in transplants was most prominent for hearts, followed by kidneys, lungs, and liver. In China, the decline was also most profound in hearts, followed by kidney and liver transplants. Notably, the number of lung transplants increased in China during 2020. This glimpse of transplantation activity echoes the issue of resource limitations and financial burden in low-income countries like India. The resource reallocation in managing the health emergency generated by the pandemic further weakened the capacity of transplantation programmes. These data show the vulnerability of deceased donation transplantation in these regions, contrasting with North America, which was able to cope with the initial decline in transplants via a well-equipped deceased donation system. We declare no competing interests. Download .pdf (.12 MB) Help with pdf files Supplementary appendix COVID-19 pandemic and worldwide organ transplantation: a population-based studyWe quantified the impact of the COVID-19 pandemic on worldwide organ transplantation activity and revealed heterogeneous adaptation in terms of organ transplantation, both at national levels and within countries, with detrimental consequences for waitlisted patients. Understanding how different countries and health-care systems responded to COVID-19-related challenges could facilitate improved pandemic preparedness, notably, how to safely maintain transplant programmes, both with immediate and non-immediate life-saving potential, to prevent loss of patient life-years. Full-Text PDF Open Access