Kidney transplants in Singapore hit by Covid-19 even as wait list grows; cases increasing as 6,168 new infections reported

SINGAPORE, June 26 (The Straits Times/ANN): The number of kidney transplants - already decreasing before the Covid-19 pandemic hit - has fallen over the past two years, even as the waiting time for a donor kidney grows longer.

In 2019, there were 33 kidney transplant operations involving deceased donors carried out in Singapore; but only 15 kidney transplants took place in 2020 and just 24 last year.

Living-donor transplants were also affected, falling from 56 in 2019 to 31 in 2020, before going up to 47 last year.

In contrast, the number of people here waiting for a kidney has steadily climbed. There were 330 people on the transplant wait list in 2019 and 371 last year. The average waiting time for a kidney from a deceased donor is now 97.4 months, or just over eight years.

Doctors said Covid-19 is to blame for the backlog, as staff were redeployed to help with pandemic operations and operations postponed, especially if the patients were deemed to be high-risk.

Associate Professor Terence Kee, who is director of the Singapore General Hospital's (SGH) renal transplant programme, said the first year of the pandemic hit especially hard.

"Even though the circuit breaker lasted only two months, more than 100 SGH patients were affected as processing of referrals and evaluations were suspended," he said.

Evaluations for living donor kidney transplants were put on hold, as was placement on the deceased-donor wait list.

"Our staff were deployed elsewhere to support Covid-19 efforts such as the isolation wards, perimeter screening and swabbing operations," said Prof Kee.

Dr Hersharan Kaur Sran from the National University Hospital's (NUH) adult kidney and pancreas transplantation programme, said her hospital's experience was much the same.

The hospital's transplant team received fewer referrals from kidney doctors, who were swamped, and transplants involving deceased donors dropped significantly due to concerns about infection transmission, among other things.

For instance, organs from higher-risk donors - such as people who were older or less healthy - were turned down, said Dr Hersharan, a senior consultant at the National University Centre for Organ Transplantation (Nucot).

This was because such transplants require more medical resources and increase the risk of recipients having to stay longer in hospital or needing intensive care.

Professor Tan Chee Kiat, who is director of the Health Ministry's National Organ Transplant Unit, said Singapore has one of the highest rates of diabetic kidney failure in the world.

About 5.7 people are diagnosed with kidney failure daily, and two in three cases of kidney failure are due to diabetes. There are more than 8,500 dialysis patients in Singapore.

For patients with end-stage disease, kidney transplants are often the best option. But even before the pandemic, the number of organs from deceased donors was already in decline, largely because they were medically unsuitable for various reasons, he said.

The Covid-19 cases in Singapore also has been increasing steadily over the past week.Singapore reported 6,168 new cases of COVID-19 on Saturday, bringing the total tally to 1,403,242.

Of the new cases, 5,654 were local transmissions and 514 were imported cases. Among the local cases, 450 cases were detected through PCR (polymerase chain reaction) tests and 5,204 through ART (antigen rapid test) tests, according to statistics released by the Ministry of Health.

A total of 353 cases are currently warded in hospitals, with 10 cases in intensive care units.

No new death was reported due to COVID-19 infection, keeping the death toll at 1,408, the ministry said. - The Straits Times/ANN

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Singapore , Covid-19 , Kidney Transplant , Hit , Pandemic


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