Photo/Illutration A card showing a willingness to donate organs (Provided by the Japan Organ Transplant Network)

The number of organ donations from deceased patients plummeted in 2020 from the year earlier because hospital staff at intensive and emergency care units were overburdened with COVID-19 patients, medical experts said.

The Japan Organ Transplant Network (JOT), the only organ procurement and allocation organization in the country, said the number of organ donors fell to 78 in 2020 from 126 in 2019, the year before the pandemic hit.

In December last year, when new COVID-19 cases were raging across the nation, there were zero organ donors for the first time since JOT began publishing monthly donor numbers in January 1998.

This year, the number of donors was 59 as of the end of October, including four in July and three in August, when Japan was struggling with the fifth wave of novel coronavirus infections.

The organ donation total so far this year is well below the annual average of 80 to 100 in recent years.

The 2021 trend is matching the sluggish pace of 2014, which has had the fewest donations since the Organ Transplant Law was revised in July 2010.

The revision allowed for organ donations from brain-dead patients based on the consent of their relatives, even if the donors had not made their intentions clear in writing.

Organ donations from deceased patients are allowed after  cardiac death and brain death.

The number of organ translant surgeries began rising after the legal revision because brain-dead patients can provide more organs than patients who died of heart failure.

In contrast, organ donations from cardiac arrest patients have declined

Of the 126 donors in 2019, brain-dead patients accounted for 98, the highest number so far, including the period before the law revision.

Patients who donated their organs after cardiac death have hovered around 30 annually over the past five years.

But there were only nine such cases in 2020. And this year, the number was seven as of the end of October.

Medical experts say the decrease in organ donations stems from surges of severely ill COVID-19 patients who required treatment at hospitals’ intensive and emergency care units.

These medical units have been stretched so thin during the pandemic that they have had little room to prepare for possible organ donations.

“Extremely painstaking efforts are needed to gain consent for organ donations at times when meeting people from outside hospitals is strictly restricted (under anti-infection measures),” said Kenji Yuzawa, transplantation surgeon at the Mito Medical Center in Ibaraki Prefecture.

Yuzawa, who also serves as chief of the committee to respond to the novel coronavirus at the Japan Society for Transplantation, said handling donations from cardiac-death patients poses a host of challenges to surgeons.

An organ must be removed swiftly after a patient’s heartbeat stops, but predicting when the heart will completely fail is exceedingly difficult, according to doctors.

In addition, doctors now are required to take an extra step of performing a PCR test on the organ donors to confirm they were not carrying COVID-19.

The virus situation has made it more difficult for doctors to present organ-donation options to relatives of the patients, Yuzawa said.

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