“We’re worried that in the present environment, the risks of dying soon after transplant are greatly increased,” Professor Chadban said.
“It is much safer to keep somebody on dialysis rather than expose them to a kidney transplant and heavy immunosuppression [drugs] whereby we believe we would greatly increase their risk of getting severe disease if they caught [SARS-CoV-2].”
Professor Chadban said there was “a distinct possibility” that patients waiting for heart, lung and liver transplants could die if ICUs reached capacity – which some experts predict will occur within weeks – as they may not be able to access a bed for their post-surgery recovery.
“We hope we won’t come to that position but, if we do, the involved doctors will have to look at the prognosis of both patients and decide who’s most likely to survive.”
The taskforce, made up of specialists who are members of the Transplant Society of Australia and New Zealand along with Donate Life and the Organ and Tissue Authority, will review its position weekly as the pandemic unfolds.
Professor Chadban, the director of renal medicine at Sydney’s Royal Prince Alfred Hospital, said some paediatric kidney transplants would be performed, where a suitable donated organ was available, for young children “at very high risk of dying in the next month or two”.
He said the risk of a transplant patient being infected with the coronavirus in an ICU would factor into the decision of whether the surgery should be performed.
Transplant Australia chief executive Chris Thomas said the coronavirus pandemic had presented transplantation doctors and nurses with “an unenviable dilemma” and having consequences “we never imagined” for patients waiting for a transplant.
“If someone received a transplant in this current environment and then was exposed to coronavirus while their immune system was recovering there could be severe complications,” Mr Thomas said.
“Continued dialysis therapy is preferred, although we acknowledge not without its own risks.”
Research shows patients who remain on kidney dialysis have poorer health outcomes over the long term, including higher death rates and decreased quality of life.
As of February, 1232 Australians were waiting for a kidney transplant, 177 for a liver transplant, 120 for lungs and 87 for a heart.
About three-quarters of kidney transplants are performed with organs from deceased donors. Donations are now limited by state borders due to restrictions on travel, narrowing the possibility of finding a donor.
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Dana is health and industrial relations reporter for The Sydney Morning Herald and The Age.