Tribune. A kidney transplant is by far the best treatment for patients whose kidneys are no longer functioning. Compared to dialysis, it greatly improves their quality and life expectancy, and also costs much less. Logically, our public policies have long advocated its development.
However, although the ethical principles and the rules governing organ harvesting and transplantation are respected, despite the regulatory and promotional role of the Biomedicine Agency, the results deteriorate dramatically. Waiting patients see their hopes dwindle and their lives slip away, while healthcare costs soar.
The 3e transplant plan, which ends this year, is a failure, and was already well before the health crisis. It provided for 4,950 kidney transplants per year in 2021, but their number never exceeded 3,800, a “record” reached in 2017. A deterioration further amplified by the Covid-19 epidemic: a thousand fewer kidney transplants in 2020 (–31%) and a worrying 2021 outlook.
This decline has several causes: crisis in the public hospital, funding theoretically earmarked but used for other purposes by hospital management, insufficient human resources, dedicated staff forced to perform other tasks, regional particularities leading to considerable geographic inequalities. . Too often, harvesting and transplantation rely on a small number of individuals of good will, and are constantly threatened by the risk of departure or disengagement.
Despite its national priority status enshrined in law in 2004, the transplant in France suffers from abnormal fragility. While it should be sanctuary and prioritized, it is one of the very first activities sacrificed in stressful hospital situations.
Other countries are doing much better
Spain is the “world champion” of collection from deceased donors, with 48.9 donors per million inhabitants (pmh) in 2019, against 27.9 pmh in France. Waiting times do not exceed a few months, while they are counted in years in France. Catalonia, the best region in Spain, reached an impressive rate of 109.9 pmh, four times that of France, without any degradation in quality: the results of Catalan and French transplants are similar.
For its part, the United Kingdom has strongly developed living kidney donation, which represents 30% of kidney transplants, against only 14% in France.
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