Kidney transplants to be delayed for unvaccinated patients until Covid crisis passes

Beaumont hospital, where the service is based, said in a statement that individuals who cannot comply with protective measures - including vaccination - will remain “active” on the transplant programme. File photo: Collins

Consultants involved with the national kidney transplant service have been advised to suspend unvaccinated patients on the waiting list until the Covid crisis passes, according to a new letter.

Beaumont hospital, where the service is based, said in a statement that individuals who cannot comply with protective measures - including vaccination - will remain “active” on the transplant programme.

However, a risk assessment will be completed, which may result in the deferral of the transplant if the risk is deemed to be “too high at that time because of inability to engage with protective measures or for any other reason”.

In a letter to consultants dated August 3, the surgical director of the national kidney transplant service, Miss Dilly Little, and Dr Colm Magee, requested they furnish them with a list of patients “who are on the transplant waiting list who are currently not vaccinated”.

“We would strongly urge patients that are potential transplant recipients be immediately vaccinated for Covid,” the letter states.

“In view of the risk of transmission, particularly of new Covid variants, we feel that it will not be possible to continue to offer transplantations to unvaccinated recipients.” 

Therefore, if your patient cannot be vaccinated, for whatever reason, we would recommend that they be suspended from the waiting list with immediate effect until the Covid crisis has passed and there is no risk of transmission of Covid for the individual patient or to members of staff or other patients who are immunosuppressed on the transplant unit.

In a statement to The Irish Examiner on Friday, Beaumont hospital said despite “significant challenges”, the national transplant programmes continue to operate through this phase of the Covid pandemic.

“Covd-19 infection carries particular risk to kidney, liver, pancreas, lung and heart transplant recipients. Following transplant, the immune system is weakened and the risk of serious illness or death from Covid-19 is exceptionally high,” the hospital said.

“In the setting of ongoing community transmission of Covid-19, patients who are unvaccinated are at very high risk. In addition to the personal risk, a transplant recipient with Covid-19 may unintentionally introduce infection to a transplant service creating a risk to other transplant recipients.” 

The hospital said that in order to protect all immunosuppressed transplant patients from the virus, it is “expected” that all individuals engage fully with the available measures to protect themselves, including vaccination against Covid-19, strict adherence to non-pharmacological interventions and cocooning at home after transplant, except for essential hospital visits.

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“In the circumstances that a transplant candidate is unable to participate in Covid-19 infection prevention measures, they will remain active on the transplant program,” the statement said.

“In the event of a donation episode, a risk/benefit assessment will be completed to determine whether a safe and successful transplant can be undertaken in all the circumstances.

It added: “Risk assessment may result in deferral of transplant surgery if the risk to the person is considered too high at that time because of inability to engage with protective measures or for any other reason.”