Urgent Need: Kidney Transplants in Germany Remain High
Germany Faces Organ Shortage Demand
In Germany, over 6000 individuals wait every year for a kidney transplant, yet only 2000 receive one. This stark reality leaves a significant number of patients on a lifelong wait, with not everyone making it through. Bettina Lange, a 68-year-old resident of Brandenburg's Brieselang, initially met this fate, but her husband's selfless act changed her life.
In early 2009, Bettina, who had been suffering from kidney disease and undergoing dialysis, received a transplant from her husband. "Dialysis made me feel very unwell," she recalls. Kidney transplants offer a crucial lifeline for these patients, yet thousands remain on dialysis, hooked up to machines for several hours three times a week.
Pioneering Footsteps in Organ Transplantation
Transplanting organs has come a long way since the first successful human-to-human kidney transplant on June 17, 1950, in a small US hospital. Richard H. Lawler, the surgeon behind the groundbreaking operation, transplanted a deceased donor's kidney into a 44-year-old patient in a 45-minute procedure. Although the transplant initially functioned, it eventually had to be removed after ten months due to the body's rejection.
In Germany, the first kidney transplant took place in 1963. Although the initial operation failed, German urologists achieved their first long-term success six months later with a 25-year-old patient who received a donation from her mother. Since then, around 100,000 kidneys have found new owners in Germany.
Securing a New Lease on Life
Typically, patients might find a match in a healthy partner, relative, or close friend. This was the case for Bettina and former Federal President Frank-Walter Steinmeier, who donated a kidney to his wife in 2010.
Following a year of preparation, Bettina and her husband underwent the procedure. "After the operation, you have two chronically ill people," Bettina reflects. Recipients must take strong medications to suppress their immune system and prevent rejection, increasing their risk of infection. They should also carefully manage their diet, avoiding specific foods like blue cheese, some citrus fruits, and pomegranates.
While many healthy donors can resume their normal lives post-transplant, regular examinations remain essential. These donors still retain about 70% of their original kidney function, which is adequate for a normal life.
Battling the Organ Shortage
Most dialysis patients rely on the organs of deceased donors. Of the 2075 kidney transplants performed in Germany in 2024, around one-third originated from living donors, while the remaining 1433 came from deceased donors. Germany's organ donation willingness is relatively low, ranking it low in European comparison. Countries like Portugal and Spain, for example, have three times the donation rate.
The organs are distributed via the Eurotransplant mediation center, which includes eight European countries. Despite receiving more transplants, Germany donates fewer organs compared to other countries like Spain.
The Long Wait for a Lifesaver
At the end of 2024, nearly 6,400 patients were on the waiting list for a new kidney, according to DSO data. With many patients estimated to require up to 30,000 kidneys, the waiting time between the start of dialysis and the operation can be lengthy, often spanning seven years for those aged 18 to 64.
A potential solution to these long wait times is an increased number of donors. Germany currently operates under an "opt-in" system, which requires individuals to explicitly consent to organ donation. Some supporters advocate for an "opt-out" system, where consent is presumed unless explicitly declined, such as in countries like Spain.
Guido Lambrecht, a 57-year-old transplant recipient and chronic kidney insufficiency patient, received his first kidney in 1992 under Germany's "opt-in" system after just two years of waiting, followed by five and a half years for his second kidney, and seven years for his third transplant in 2018. He mused, "Funny enough, I've always waited the average time."
Insights:
- Donor Consent: Germany employs an "opt-in" system,where individuals must explicitly consent to organ donation. Some research suggests that "opt-out" systems, where consent is presumed, generally result in higher donation rates.
- Donation After Circulatory Death (DCD): Germany primarily focuses on donation after brain death (DBD), with limited inclusion of DCD donors. However, including both types of donors may increase the number of available organs.
- Public Trust: Public trust in the organ donation system plays a role in donation rates, with some countries demonstrating higher rates due to strong public awareness campaigns.
- Healthcare Infrastructure: The availability of healthcare resources, such as hospital beds per million population, can affect organ donation capability. While Germany boasts a robust healthcare system, further analysis may be needed to determine its impact on donation rates.
- Legal and Policy Frameworks: Changes in legal and policy frameworks governing organ donation can impact public support and participation in organ donation programs.
These factors highlight the complexity of organ donation rates and the need for multifaceted strategies to improve donation figures in Germany.
- The community policy regarding organ donation in Germany employs an "opt-in" system where individuals must explicitly consent to donation.
- A potential solution to the long wait times for kidney transplants in Germany is a shift to an "opt-out" system, where consent is presumed, as seen in countries like Spain.
- Donors of kidney transplants typically continue regular examinations after the procedure to ensure their health.
- Healthy donors usually retain about 70% of their original kidney function, allowing for a normal life post-transplant.
- Sciene has made significant strides in organ transplantation since the first successful human-to-human kidney transplant in 1950.
- The first kidney transplant in Germany took place in 1963, with the first long-term success occurring six months later.
- Since the first German kidney transplant, around 100,000 kidneys have found new owners in the country.
- While many patients rely on deceased donors for kidney transplants, living donors provide about one-third of transplants in Germany.
- Countries like Portugal and Spain have demonstrated higher organ donation rates compared to Germany.
- Organ distribution in Germany and other European countries is facilitated by the Eurotransplant mediation center.
- Chronic kidney disease patients, like Bettina Lange and Guido Lambrecht, can wait several years for a kidney transplant in Germany.
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