A COVID-19-járvány hatása a szervadományozásra és -átültetésre Magyarországon 2020-ban.
2021
Osszefoglalo. Bevezetes: A SARS-CoV-2-vilagjarvany terjedese drasztikus valtozasokat okozott a mindennapi betegellatasban, amelyek erintettek a szervadomanyozas es -atultetes teruletet is, igy csokkent az elő es az elhunyt donorokbol tortenő donaciok es transzplantaciok szama vilagszerte. Az esetszam csokkenese mellett a transzplantalt es egyben immunszupprimalt betegek vedelme erdekeben tovabbi biztonsagi intezkedeseket kellett bevezetni. Modszer: A vizsgalat celja a COVID-19-jarvany hazai donacios es transzplantacios aktivitasra gyakorolt hatasanak kimutatasa volt 2020-ban, a megelőző evvel tortenő osszehasonlitasban. A magyar eredmenyeket osszehasonlitottuk elsősorban az Eurotransplant, illetve az Europai Unio tagallamainak adataival is. Eredmenyek: A lakossagszamra sulyozott, regisztralt COVID-19-fertőzottseg es -halalozas tekinteteben nem igazoltunk 2020-ban kiemelkedő elterest itthon az Eurotransplant-tagallamokhoz kepest. A hazai szervdonacios potencial nem csokkent a vizsgalt időszakban, ugyanakkor 38,33%-kal csokkent az agyhalott szervdonorok szama Magyarorszagon, mig az Eurotransplantban atlagosan 8,64%-kal es 23 adatkozlő europai orszagban 17,55%-kal. Az elhunytbol tortent szervatultetesek szama 29,27%-kal csokkent, kulonosen a sziv- es a majatultetesek eseten. A kulfoldről kapott szervek szama 21,13%-kal es aranya 12,34%-kal emelkedett. Az elő donoros veseatultetesek szama nem valtozott. 2020-ban 25%-kal kevesebb uj beteget regisztraltak, mint 2019-ben, es a varolista-mortalitas 28%-kal novekedett az előző evhez kepest, kifejezetten a veseatultetesre varok kozott. Kovetkeztetes: A hazai szervatultetesi program biztonsagos: donoreredetű SARS-CoV-2-atvitel nem tortent hazankban. A szervdonacios potencial es a COVID-19-jarvany mellett a szervdonacios es -transzplantacios aktivitas jelentősen csokkent Magyarorszagon 2020. marciustol az ev vegeig. A legtobb europai orszagban atmeneti es kisebb mertekű szervdonacios csokkenest regisztraltak. A szervatultetesek szama nem csokkent olyan mertekben, mint a donorszam, mert az Eurotransplantbol tobb donorszerv erkezett hazankba, mint amennyit kulfoldre kuldtunk. Orv Hetil. 2021; 162(23): 890-896. SUMMARY INTRODUCTION The spread of the SARS-CoV-2 pandemic has resulted in drastic changes in day-to-day patient care, which has also affected the field of organ donation and transplantation, thus reducing the number of donations and transplants from living and deceased donors worldwide. In addition to the reduction in the number of cases, additional safety measures had to be introduced to protect transplanted and implicatively immunosuppressed patients. METHOD The aim of the study was to demonstrate the impact of the COVID-19 epidemic on domestic donation and transplantation activity in 2020, compared to the previous year. We also compared the Hungarian results with the data of the Eurotransplant and the European Union member states. RESULTS In terms of population-weighted, registered COVID-19 infection and mortality, we did not find a significant difference in Hungary in 2020 compared to the Eurotransplant member states. The national organ donation potential did not diminish in the period under review, however, the number of brain-dead organ donors decreased by 38.33% in Hungary, while in the Eurotransplant it did by 8.64% on average and in 23 reporting European countries by 17.55%. The number of organ transplants from the deceased decreased by 29.27%, especially regarding heart and liver transplants. Both the number and the proportion of organs received from abroad increased by 21.13% and 12.34%, respectively. The number of living donor kidney transplants did not change. In 2020, 25% fewer new patients were registered than in 2019 and the mortality on waiting list increased by 28% compared to the previous year, especially among those waiting for a kidney transplant. CONCLUSION The national organ transplantation program is safe: donor-derived SARS-CoV-2 transmission did not occur in Hungary. In addition to the organ donation potential and the COVID-19 pandemic, organ donation and transplantation activity decreased significantly in Hungary from March 2020 until the end of the year. Transient and smaller reductions in organ donation rates have been reported in most European countries. The number of organ transplants did not decrease as much as the number of donors, because more donor organs arrived in Hungary from the Eurotransplant than we sent abroad. Orv Hetil. 2021; 162(23): 890-896.
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