Rise in organ transplants continues after difficult Covid years

The Biomedicine Agency today unveiled the figures for organ and tissue transplants performed in 2022.

A little better, after two years complicated by the covid-19 pandemic. Despite a year 2022 marked by a triple epidemic of influenza, Covid-19 and bronchiolitis which undermined the hospital, “the number of transplants reached in 2022 is encouraging” even if it has not yet returned to its pre-crisis level, underlines in a press release Professor François Kerbaul, director of organ and tissue removal and transplantation at the Biomedicine Agency. “We are going through an extremely deep hospital crisis and I salute the mobilization of the teams, because without these professionals, this energy that they deploy, these transplants would not take place”insisted at a press conference Marine Jantet, the new director general of the Biomedicine Agency.

From the side organ transplants, the overall increase is 4% compared to 2021, with 5,494 transplants performed (compared to 5,901 in 2019, before the health crisis). It is, on the one hand, the fruit of a “better census of people who died by brain death”underlines the agency (2,984 donors identified in 2022, up 6.1% compared to 2021, and 1,459 donors actually collected, +4.8%). “Maastricht III” direct debitson a donor who is not brain dead but for whom it has been decided to stop treatment, are also on the rise with 235 patients sampled compared to 217 (for 609 identified) in 2021. This method of sampling, authorized in France since 2015, is still struggling to establish itself but is progressing slowly.

The removal of tissues (cornea, blood vessels, skin, heart valves and bone) is also on the rise. 6,226 deceased donors were removed in 2022 (+5.5% compared to 2021, and +29.1% compared to 2020). Here again, the pre-pandemic level has not yet been reached, except for vein sampling, which is experiencing the strongest increase with +43.5% compared to 2021, and +196.6% compared to 2021. compared to 2019.

A need for communication

Overall activity, however, remains lower than before the health crisis, underlines the Biomedicine Agency. “All the efforts made by health professionals, patient associations, hospital administrations, health authorities and learned societies will not make it possible to achieve the objectives set by the transplant plan and linked to patient expectations, if the hospital situation does not improve“, emphasizes Professor Kerbaul.

And France is still far from meeting the needs: all bodies combined, at the 1is January 10,810 patients were on the active waiting list, immediately eligible for an organ transplant. Every day in 2022, there were 21 new registrations on the waiting list for 15 transplants performed, and 2 to 3 people die for lack of having been transplanted. The Biomedicine Agency therefore hopes that the 2022-2026 “transplant plan” launched by the government will make it possible to improve things, with additional funding (210 million euros more allocated for five years, within an overall effort of 2 billion euros) and better organization of the sector and between the actors. “The objectives defined by the transplant plan are 1643 to 2084 donors with brain death removed from at least one organ in 2026.explained Professor Kerbaul. For 2022 we are close to the upper limit of the planned progression curves, so it is extremely encouraging.

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But it will also be necessary to play on better communication with the French. “One of the main levers on which we must act to strengthen this national priority activity is to reduce the rate of opposition to direct debiting, which is particularly high in France”, insisted Marine Jeantet, new Director General of the Biomedicine Agency. The barometer* conducted at the beginning of each year by the Agency to assess French people’s perception of organ and tissue donation shows that they have a good image of organ donation (80% of respondents feel that this law is in line with their values, and the same proportion are in favor of donating their own organs after their death). But in fact, only 47% have spoken about it to their relatives.

Consequently, the rate of opposition for the deceased eligible for donation is at a fairly high level, around 30%. Indeed, even if the law considers everyone as a donor by default if they have not indicated their opposition during their lifetime, many relatives find themselves unable to decide on the wishes of the deceased when the question of organ donation arises. laid. For lack of having talked about it before, relatives often fall back on “a position of caution (…) which in fact prohibits the taking”says the Agency.

Moreover, a little more than half of French people do not feel concerned by organ transplantation, and 22% consider that they cannot be a donor because of their age or a medical history. However, in reality, very few pathologies prohibit donation and age is not an obstacle: 41% of donors collected in 2022 were over 65 years old, and this figure is much higher in certain European countries. “Otomorrow, everyone can be a recipient or donor of an organinsisted David Heard, spokesperson for the Biomedicine Agency. There is a real challenge in bringing out the subject in the media, in public opinion, and that everyone devotes time to discussing this issue. There aren’t many other areas where talking about it is enough to save lives.

*Annual Biomedicine Agency / Viavoice survey of a representative sample of the French population of 1,012 people aged 16 and over.

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