Each beginning of the year is an opportunity for the Biomedicine Agency to take stock with regard to the activity of sampling and organ donation in France over the past twelve months. After a first observation announced last fall, it confirms a drop in activity in 2018 after 8 years of strong growth. “While the start of 2018 foreshadowed a very significant drop in activity, all players in the transplant sample were mobilized and helped to reverse the trend to limit the drop in activity to -5% “, She specifies. This is a drop across all organs: 5,781 transplants were performed in 2018, or 324 fewer transplants than in 2017.
More specifically, the agency reveals that 281 transplants were performed thanks to a Maastricht III type donation (compared to 234 in 2017, i.e. + 20%), i.e. from donors who died after cardiac arrest following a scheduled cessation of treatment. 551 transplants were performed from living donors (compared to 629 in 2017) and 1,743 from donors in a state of brain death(1,796 in 2017). Experts cite three reasons to explain this drop, the first being a drop of around 15% in mortality from stroke, leading to a drop in the number of potential donors identified as having brain death (brain death).
The population less opposed to presumed consent
“This is why the Agency is pursuing the diversification of other sources of grafts: living donation, Maastricht II (donors who died after cardiac arrest following a failure of resuscitation attempts) and Maastricht III (deceased donors after cardiac arrest following a scheduled cessation of treatment), ”she adds. The second reason cited is the flu epidemic in winter 2018 which strongly mobilized the hospital teams and in particular the resuscitation services. Not to mention that other European countries are also experiencing a decline in their activity. Despite this observation, the Agency is optimistic because this decline does not prevent the good news.
First, the law is not at issue. The drop in activity is not linked to the strengthening of presumed consent in 2017, a measure adopted as part of the law to modernize our health system. “Public opposition to organ donation has not increased since this law. On the contrary, the refusal rate expresses a downward trend (33% in 2016, 30.5% in 2017 and 30% in 2018), ”the Agency said. As a reminder, in France the law indicates that we are all suspected organ and tissue donors unless we have expressed our refusal to be collected during our lifetime. Through the national register of refusals or opposition expressed orally or in writing to relatives.
A revival of activity at the end of 2018
The Agency also specifies that its drop in blood harvesting and transplant activity is less significant than expected. It has been able to start rising again in the last few months of the year, which is why instead of an expected drop of around 10% in view of the first months, 2018 ended with a 5% decrease in activity. “ The graft is an exceptional treatment. However, its frequency does not make it a “normal”, routine act “, underlines the Agency. The latter is also pleased that all types of transplant activity are not declining: Maastricht III-type removals, initiated in late 2014, continued to increase in 2018 with more than 280 transplants performed.
To date, 26 hospitals are authorized to perform Maastricht III-type samples in France when they were only 20 in early 2018. Last good news: there have never been so many samples and transplants in the departments overseas, especially kidney transplants with an increase of + 139% for Reunion and + 32% for Guadeloupe. “The involvement of everyone, in order to maintain the efforts made at the end of 2018, is necessary in order to allow ever more patients to access this vital therapy”, concludes the Biomedicine Agency which evokes the importance of the “Plan transplant” 3 »2017-2021 with the overall objective of carrying out 7,800 transplants in 2021.
Transplants: “30% of organs are refused for medical reasons”
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