It is standard practice to require vaccinations before transplants, experts say, because anti-rejection medications make recipients immune-suppressed and put them at extremely high risk of dying from infections, including the coronavirus.
In Canada, Toronto’s University Health Network (UHN) is the country’s largest transplant center, with nearly 4,300 Canadians awaiting an donor organ. Physicians recently enacted a precedent-setting policy of requiring patients to be fully vaccinated against COVID-19 in order to be considered for a life-saving organ transplant, according to CTV Canada.
“From a medical point of view, we all felt quite strongly that this was needed. So, we’ve been having a lot of discussion on how best to formulate this policy,” Dr. Atul Humar, director of UHN’s Ajmera Transplant Centre, told CTV National News.
In a statement put out explaining the decision, UHN said: “There is ample research to support that the best course of action is to vaccinate individuals prior to transplant, whenever possible. Just as with other medical requirements, the COVID-19 vaccination helps ensure the best possible outcome for our patients.”
Dr. Humar also pointed out the policy is not that unusual. “You can’t be actively drinking and be listed for a liver transplant you can’t actively be smoking and be listed for a lung transplant and this is the same kind of thing really.”
Transplant patients in the U.S. are no different
While UHN’s new protocols are a first for Canada, in the United States, a similar protocol has already been creating life-and-death debates.
Health systems in Colorado and Washington are removing unvaccinated patients from organ transplant lists, given research that shows unprotected recipients are much more likely to die from Covid-19.
Leilani Lutali, a Colorado woman and a born-again Christian with stage 5 kidney disease, was denied a life-saving kidney transplant because she says she cannot agree to be vaccinated on religious grounds. Lutali had already lined up her organ donor, and both she and the donor were taken off the transplant list.
“It feels a little bit like my transplant is being held hostage and there’s only one decision that I’m being left with,” she told CTV National News.
State representative Tim Geitner, a Republican, went even further, tweeting a copy of the letter Lutali received on Tuesday and adding that the health system “denies life-saving treatment.”
However, a spokesperson for the University of Colorado Health (UCH) said in a statement: “For transplant patients who contract COVID-19, the mortality rate ranges from about 20% to more than 30%. This shows the extreme risk that COVID-19 poses to transplant recipients after their surgeries.
In almost all situations, transplant recipients and living donors at UCHealth are now required to be vaccinated against COVID-19 in addition to meeting other health requirements and receiving additional vaccinations. Some U.S. transplant centers already have this requirement in place, and others are making this change in policy now.”
It should also be noted that UCH also requires that transplant recipients receive other vaccinations, including hepatitis B and MMR vaccines, according to FOX News.
The University of Washington Health Center also requires transplant patients to have the vaccine, or they will be removed from the waitlist and deemed ineligible for a transplant unless they have a specific medical exemption.
UW Medicine echoed UCHealth’s policy, saying they have for years required up-to-date vaccinations for all patients on transplant waiting lists. The difference now is that COVID-19 vaccination is on the list, too.
There are more than 100,000 people on the organ donation waiting lists in the US, but only 39,000 transplants occur each year. And regardless of if a patient is waiting to receive an organ donation in Canada or the U.S., there are requirements patients must follow in order to have the safest outcome from the surgery.
While many people believe the COVID-19 vaccine should remain a patient’s personal choice and not compromise that person’s ability to get a life-saving transplant, think about this – Unvaccinated organ recipients have a 25 percent higher risk of severe infection or death.
Dr. Dorry Segev, a transplant surgeon and professor of epidemiology at Johns Hopkins, told the Guardian, “If we think that they have too high a chance of dying if they get transplanted, then they are not a good candidate for this resource, which is a scarce resource and has to be shared across all patients across the country.”
