Their message is clear: organ transplantation is “a vital priority in danger”.
In a column that we publish, several organizations of doctors and patients believe that “the transplantation activity suffers both from the ills of the hospital and from the lack of application of its priority status”.
The number of transplants performed started to rise again last year in France, but still remained far from pre-Covid levels.
Here is their “cry of alarm”.
Organ transplants: a vital priority in danger
Unparalleled therapeutic, both a medical and logistical feat, the transplant of organs and tissues – from deceased or living donors – is vital.
While nearly 22,000 patients are waiting for an organ transplant, more than 800 will have died in 2023 because they did not receive a transplant.
The 2022-2026 Transplant plan, unveiled by the Ministry of Health and Solidarity on March 14, 2022, clearly stated: organ harvesting and transplantation are public health activities which constitute a “national priority”.
Innovations, funding, roadmap and quantified objectives then outlined the contours of an ambitious and necessary program.
Despite some encouraging figures, the transplantation activity, which is struggling to return to its pre-Covid level, is suffering both from the ills of the hospital and the lack of application of its priority status.
Transplantation, the referral activity par excellence, can only be carried out in university hospital centers (CHU).
Established as a national priority, it is therefore binding on everyone and should be developed and supported in all its components.
A directive which, however, repeatedly comes up against the hospital situation and material, human or logistical inadequacies, more or less pronounced depending on the territories and establishments.
We note that several factors have a negative impact on organ procurement and transplantation, particularly for kidney transplants carried out from living donors.
Among these obstacles, numerous difficulties in accessing operating theaters, complex decisions regarding prioritization of activities within CHUs – whose missions deserve to be refocused –, a glaring lack of nursing staff and the absence of clear signage of the resources allocated to the transplant, seem particularly problematic to us.
Already leading to major delays in care and loss of opportunity for patients and their families, these difficulties weigh on the daily lives of caregivers and the coordination teams mobilized.
Added to these obstacles is the unprecedented increase in the rate of opposition to organ donation, which currently reaches 36.1% in France and is affecting the capacity for growth of transplantation activities in our country.
In order to meet the objectives of the Registry plan, we are collectively proposing some concrete solutions, which should be implemented without delay:
- Prioritize collection and transplantation activities in a concerted manner within establishments and protect operating times dedicated to transplantation activity from living donors
- Strengthen coordination teams and attractiveness for the entire sector, particularly young health professionals
- Actively support the entire medical and surgical community participating in the transplant sector, from access and registration to the waiting list, to the organization of follow-up after transplantation
- Ensure that part of the funding dedicated to the transplant and collection coordination teams is redistributed, in order to strengthen human resources and access to technical platforms
There must be neither fatality nor resignation.
All available levers must be activated with hospital management, caregivers and patients, to promote the achievement of the objectives of the 2022-2026 Transplant plan and support the work of hospital collection coordination and transplantation teams.
We are all mobilized together to face the human, medical, technical and logistical challenges specific to organ transplantation.
But without concrete guarantees from our authorities and without the necessary means, this “national priority” – and the patients who depend on it – will continue to pay the price for a public health policy that turns its back on its commitments.
The petitioners
French-speaking Society of Transplantation (SFT);
French Society for Organ and Tissue Harvesting Medicine (SFMPOT);
French-speaking Society of Nephrology, Dialysis and Transplantation (SFNDT);
French Association of Urology (AFU);
Federation of associations for the donation of human organs and tissues (France ADOT);
Transplants + (the Graft of Life Foundation, France Heart and Lung Transplant Federation, France Rein, Transhepate, Overcoming Cystic Fibrosis, Association Grégory Lemarchal, the French Association of Families for Organ Donation, Maryse! for Life);
Renaloo;
Trans-Form.