Hospital reverses advice to delay transplants for unvaccinated patients

Beaumont Hospital has withdrawn a recommendation from top doctors to suspend patients unvaccinated for coronavirus from the waiting list for a kidney transplant.

The move came more than a fortnight after a letter was issued to consultants, saying it would not be possible to offer transplants to unvaccinated people because of Covid transmission risks.

Still, the hospital said it expected all individuals to “engage fully” with Covid protection measures such as vaccines, mask-wearing, social distancing and cocooning at home after transplant.

The letter of August 3rd was signed on behalf of Beaumont by Dilly Little, surgical director of national kidney transplant service, and Colm Magee, the clinical director of transplantation, urology and nephrology.

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Although campaigners for the 500 people on the waiting list say many of them are very keen for coronavirus vaccinations and booster shots, the letter prompted one person to complain to a TD of “medical apartheid” against unvaccinated people.

Beaumont Hospital issued a statement on Friday in response to press queries to say “no patient, regardless of vaccination status, will be or has been removed from the transplant list”.

A hospital spokesman said such advice superseded the letter of August 3rd, meaning it had been withdrawn.

The statement said: “In the event of a [kidney] donation, 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.”

Heightened risk

Carol Moore, chief executive of the Irish Kidney Association, said there were 123 transplants last year, down from 153 in 2019 after coronavirus disruption.

“We would have a problem if people were simply taken off the list, but that is not our understanding of what is happening,” Ms Moore said.

The letter of August 3rd cited increased risks from new Covid variants: “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.”

The hospital on Friday said coronavirus 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 added: “In order to protect all immunosuppressed transplant patients from Covid-19 to the greatest degree practical, it is expected that all individuals engage fully with available measures to protect themselves from acquiring Covid-19 and thus to minimise the risk of exposing themselves or other transplant recipients to Covid-19.”

Transplant candidates unable to participate in Covid infection prevention measures “will remain active” on the transplant programme, it said.