MONTREAL -- While the number of organ donations declined during last year's pandemic, the medical director of organ donation at Transplant Quebec expects the picture to be less bleak during other waves.

In an interview during National Organ Donor Week, which ends Saturday, Dr. Matthew Weiss said one of the reasons for the 20 per cent decline in 2020 was a lack of knowledge about COVID-19.

Experts did not know the risk of transmission from a donor to a recipient. Because the recipient is immunosuppressed, it would be very risky for him or her to contract the disease.

So over the year, specialists were more "conservative" in their decisions to protect the recipient, Weiss said.

Over time, however, they have finally determined that the risk is minimal, and the procedure is very safe, he explained.

Doctors will never take organs from a patient who has the active virus -- if the cause of death is COVID-19.

The more difficult question is whether there is someone who has recovered from COVID-19.

"That's something that's more sensitive and each case is evaluated individually because the risks are there, but much, much diminished," said Weiss. "There's a risk, too, if you don't take an organ."

The patient is kept informed throughout the process and can always decline if they are concerned.

"We'll disclose that (the donor) had COVID say two months ago, that we have every reason to believe it's resolved: do you want to proceed or not," he said.

Currently, there are no cases of transmission through organ donation in Quebec, Weiss noted. Worldwide, there have been two cases of transmission in lung transplants, he added, but screening protocols were less sophisticated than they are now.

Patients seeking organ donation, even if they are immunosuppressed, are encouraged to receive the COVID-19 vaccine.

"They may have a less effective response to the vaccine," said Weiss, adding that this would not be dangerous.

Even with this advance in knowledge, which could speed up the pace, there is no doubt that offloading and postponing surgeries could continue to affect transplantation activities.

"But I would say I'm optimistic that we'll have a little less of a decrease because we're more prepared this time around with what we know today," the doctor predicted.

Weiss encourages Quebecers, despite the pandemic, to continue to come forward if they want to donate their organs because if the waiting list hasn't grown too much lately, it could when the pandemic ends.

Some patients may need an organ, but because they did not see a health-care professional during the pandemic, they are not added to the list.

Weiss and his colleagues are watching very closely to see what happens to the waiting list once the pandemic is behind us.

-- this report by The Canadian Press was first published April 24, 2021.