2021 annual figures: number of organ transplants stabilized; waiting list increases.

The coronavirus pandemic had less impact on the number of organ donations and transplants in 2021 than in 2020.

Despite the ongoing pressure on healthcare capacity, particularly in the ICU, it was possible to keep organ donations and transplants going as much as possible. At the same time, the number of Dutch people waiting for a kidney, heart, or lung has increased.

At the start of the coronavirus pandemic in 2020, there was a significant decline in the number of organ donations and transplants. In 2021, it was possible to keep as many procedures as possible going; a total of 1,240 organ transplants (from both deceased and living donors) were performed. The number of organ transplants with organs from deceased donors is 3% higher in 2021 (759) than in the previous year (734). The number of transplants with organs from living donors (kidney and liver) increased by 21% (total 481 versus 399). However, the number of organ transplants is still not at the level it was before the coronavirus pandemic. This is mainly because the number of transplants with organs from living donors is 8% lower compared to 2019.

Bernadette Haase, Director of NTS: “We have great appreciation for the fact that healthcare professionals provided this life-saving care with urgency despite all the difficult circumstances. And we have deep respect for the choice of donors and their relatives to donate, even though, due to all the corona measures, saying goodbye sometimes took place under very difficult circumstances.”

The number of tissue donors increased significantly in 2021 (and in comparison with organ donation) (26%). The number of tissue donations is even higher than before the coronavirus pandemic. This may be a first visible result of the new donor law. However, because the law was only fully implemented halfway through 2021 and due to the mixing with the coronavirus pandemic, the effect is difficult to measure. For organ donation, the numbers are too small to estimate the effect of the new donor law.

Increase in waiting list

Despite the stabilization in the number of transplants, the active waiting list for organ transplantation with an organ from a deceased donor has increased (+3%). In total, 1,298 people in the Netherlands are waiting for a new organ from a deceased donor, compared to 1,257 last year. The waiting list has increased the most for kidneys (+9%), hearts (+5%), and lungs (+3%); only for a liver has the waiting list decreased. The largest group waiting for a new organ are kidney patients. On December 31, 2021, there were 877 people on the waiting list for a new kidney from a deceased donor.

Haase: “It is worrying that the waiting lists have increased. For all these 1,298 people who are on the waiting list for a new organ, transplantation is of vital importance. A patient on the waiting list lives for a long time in uncertainty about whether an organ will become available in time, and has a more limited quality of life during that period.”

Dr. Rogier Hoek, pulmonologist at Erasmus MC, chairman of LOTTO: “For patients waiting for a new heart or lungs, it is an extremely uncertain time. Mortality on the waiting list is high; one in seven dies because a donor heart is not available in time. The fact that the waiting list for a new organ has increased underscores the importance of new developments such as DCD heart donation; a procedure in which the stopped heart of a deceased donor is placed in a machine outside the body where it starts beating again after the supply of oxygen and blood. An important key to success is the cooperation between all parties involved in transplants. It is expected that with the decline of the pandemic, the number of lung transplants will rise again to the level of 2019.”

Dr. Aiko de Vries, internist-nephrologist at LUMC, chairman of LONT: “Kidney transplants provide significant health benefits, both in terms of survival duration and quality of life. It is extremely worrying that a backlog of dialysis patients has emerged. This is due to both reduced flow to kidney transplantation and increased inflow onto the waiting list. As a result, dialysis care is under great pressure in parts of the Netherlands. It is of great importance for kidney patients that transplants with kidneys from living donors are given the same high priority as transplants with organs from a deceased donor in order to catch up on the backlogs.”