Posted on Jan 12, 2022, 4:55 p.m.
It is an operation that can change a life. However, in France, organ transplants remain far from meeting demand. And the Covid crisis does not improve a situation with complex springs.
In 2021, 5,273 transplants took place in France. Kidney transplants represent two thirds of operations. If this figure marks a significant increase compared to 2020 (+ 20%), marked by the Covid epidemic and the suspension of several interventions, it remains below the pre-crisis level, recalls Emmanuelle Cortot-Boucher, director general of the Biomedicine Agency.
Increased mortality
Compared to 2019, the last year before the crisis, the drop in transplants remains significant, around 10%. At the same time, the number of applicants continues to increase with more than 20,000 people waiting. “This year 2021 will have been the one in which we felt the effects of the long-term health crisis”, underlines the director of the Agency which oversees the universe of organ transplants in France. The trend, with more or less marked variations, is the same for all transplanted organs: reins, pancreas, heart, lungs, livers all recorded a marked increase from 2020, but a broader downward trend.
Covid affects the hospital system and, therefore, the level of transplants. During epidemic waves, such as the one currently linked to Omicron, operating theaters are quickly saturated and can less often be used for transplantation. The Covid also poses other problems, once the transplant has been carried out. The immune system of the beneficiaries is affected by anti-rejection drugs, which makes them more prone to the disease. Mortality has therefore increased in new transplant recipients since the start of the crisis.
But the Covid is not the only explanation for the slowdown in transplants. Their pace was already declining before, following a peak in 2017. The causes are multiple and it is complicated to answer, because it is sometimes the consequence of good news.
A high refusal rate
Thus, “strokes are increasingly taken care of and road fatalities are decreasing, which we can only rejoice”, notes Emmanuelle Cortot-Boucher. Organs are largely harvested from people who have died in these circumstances.
Transplants also face a high refusal rate. It represents a third of the situations where a transplant might take place. A relative of the deceased can indeed oppose organ donation if he thinks that the person would not have wished it.
It is therefore important to warn those around you that we are in favor of having an organ removed in the event of death so “that people who are likely to donate can actually do so,” recalls Emmanuelle Cortot-Boucher. For the time being, the Agency does not set objectives for the coming years, referring to work “in progress” at the ministry in order to set a new plan over several years in the coming weeks.
