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Patient groups involved in the Irish Donor Network (IDN) have expressed their deep concern about the marked decline in the rates of organ donation and transplantation in Ireland between 2019 and 2020, a period that includes the onset of the Covid-19 pandemic. The IDN further expressed deep concern that Ireland is struggling in respect of organ donation and transplantation compared with other EU28 countries, slipping from 14th place in 2019 to 18th place in 2020 in respect of transplantation, and being in 17th place for organ donation. The IDN comprises nine patient groups concerned with organ donation and transplants in Ireland, including, for example: Cystic Fibrosis Ireland; COPD Support Ireland; Cystinosis Ireland; the Irish Lung Fibrosis Association; the Irish Thoracic Society; the Irish Heart and Lung Transplant Association; and the Alpha-1 Foundation Ireland. The network is calling on Government to undertake a range of measures to revive organ donation and transplantation in Ireland, including: Developing an ambitious plan to bring Ireland into the top- 10 EU countries for transplantation and organ donation; increasing investment in facilities and staffing; and enacting the Human Tissue Bill to introduce soft optout organ donation.

The figures are revealed in the recently-published annual Council of Europe Report Newsletter Transplant 2020. Both reports from 2020 and 2019 reveal that Ireland has been struggling to keep up with many of our EU neighbours in respect of organ donation and transplant rates, even before Covid-19 severely disrupted services. IDN analysis of the figures (Annex 1) shows: DONATION AND TRANSPLANTATION Deep concern over significant decline in transplantation and organ donation rates There was a 32.1% decline in solid organ transplantation in Ireland in 2020 compared with 2019. There was a 27.1% decline in deceased organ donations in Ireland in 2020 compared with 2019. Ireland slipped to 18th place in 2020 in respect of our overall rate of all organ transplants, compared with 14th place in 2019.

In 2020, Ireland was only 17th out of the EU28 countries in respect of the deceased organ donation rates, marginally up from 18th position in 2019. The most impacted transplant programmes in 2020 were: All lung transplants down 58.2% in 2020 compared with 2019. All heart transplants down 42% in 2020 compared with 2019. All liver transplants down 44.9% in 2020 compared with 2019. All kidney transplants, from both living and deceased donors, down 21.3% compared with 2019. Pancreas transplants in Ireland bucked the overall trend and actually increased from 2019 to 2020, though the actual numbers of transplants involved are smaller (two transplants in 2019 compared with five in 2020). Mr Philip Watt, Chairperson, Irish Donor Network and CEO, Cystic Fibrosis Ireland, commented: “The Irish Donor Network is aware that one of the key reasons for the decline in transplants in Ireland between 2019 and 2020 is that transplant resources, including clinical staff, were diverted to treat Covid-19 patients, or because transplants and assessments were paused due to facilities being adjacent to Covid-19 wards.

This is likely to explain, for example, why the heart and lung transplant programme in the Mater Hospital was most disrupted by Covid-19 compared with all transplant programmes. “… A full review and analysis needs to be undertaken by Government to determine all the factors leading to these challenges, including under-resourcing of organ donation and transplant infrastructure. We are also concerned about the continuing delays in bringing in soft opt-out organ donation promised in successive Programmes for Government. While we welcome Minister Donnelly’s commitment to publish the legislation later this year, we remain worried at potential further slippage.”