Kidney transplant: in the face of regional inequalities, the attribution method challenged

In France, the time to obtain a kidney transplant varies from 13 to 66 months depending on the region. Magali Leo, spokesperson for the Renaloo association, has just contacted the Defender of Rights, the National Consultative Ethics Committee (CCNE) and the Ministry of Health to question this method of attribution.

In Caen, Rennes, Marseille, Poitiers and Brest, waiting times for kidney transplants are less than 1 year and a half, while they are longer than 4 years in Créteil, Saint Louis, Foch or Tenon (for Foch and Tenon, waiting times even exceed 5 years). The median national waiting time (after which half of the patients enrolled between 2011 and 2016 are transplanted) also increases steadily. It was 31.3 months in 2016, just over two and a half years.

66 months waiting

In France, a health facility that carries out a collection of both kidneys from a deceased donor has the possibility of keeping one to assign to a patient registered locally on the waiting lists. As a result, the time required to obtain a kidney transplant varies from 13 to 66 months depending on the region.

"According to the population basin, this gives median wait disparities of 1 to 5 years, is moving the nephrologist Lionel Rostaing in the Parisian. The criteria are more geographical than medical. For some patients, this has a negative impact on their chance of survival, others receive grafts of lower quality ".

Defender of Rights

Changing your location is not the answer. Hursine Ozkul, who has to wait at least five years for a kidney transplant, testifies in the daily: "not everyone accepts patients elsewhere! And that means giving up the medical team to which you are accustomed".

Magali Leo, spokesperson for the Renaloo association, has just contacted the Defender of Rights, the National Consultative Ethics Committee (CCNE) and the Ministry of Health. She asks the Agency for Biomedicine, the body responsible for transplants, to "end the practice" of the local kidney transplant.

15,470 patients awaiting renal transplant

Renal transplantation is used to treat end-stage renal failure, which is reached when 80% of the functional units of both kidneys are destroyed. The main causes of this pathology are diabetes and long-term hypertension.
According to the Biomedicine Agency, more than 76,500 people suffer from end-stage renal failure in France. Of the 15,470 patients waiting for a kidney transplant in 2015, only 3,486 (an increase of 7.9% compared to 2014) were able to benefit, of which 547 from living donors, 15.7% kidney transplants.

Since 2011, the Bioethics Law has widened the circle of potential donors; It is now possible to donate a kidney while alive to a family member but also to a close friend, which has helped in part to increase living donor kidney transplant by 177% in 10 years.

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