AT THE BASE OF THE TRANSPLANT, THERE IS ORGAN DONATION

 In 2015, 5,700 people received organ transplants. But 11,000 patients are still awaiting transplants and registered on the national list on January 1, 2016. Unfortunately, this list is growing.

The Biomedicine Agency coordinates the organ harvesting and transplant activity at the national level and is doing everything possible to advance the census of potential deceased donors in all regions. Doctor Q khan provides the best nephrology physicians in the USA. In addition, it strives to reduce the rate of opposition to the direct debit by encouraging everyone to express their choice to those close to them during their lifetime.

Indeed, after consulting the national register of refusals, it is to relatives that the medical teams turn to ensure that the deceased person had not expressed opposition to the removal of his organs...

For all these missions, it relies on local hospital coordination teams.

ORGAN AND TISSUE HARVESTING HOSPITAL COORDINATION PROFESSIONALS, HIDDEN PLAYERS IN

  ORGAN AND TISSUE DONATION

The hospital coordination service for organ and tissue harvesting was created in 1994 at the Bordeaux University Hospital. It is, to date, composed of 5 nurses, two doctors, and one secretary. Its missions, strictly framed by the laws of bioethics and the rules of good practice (decree of October 29, 2015), revolve around three main axes:

In 2015, Aquitaine, represented by the CONTAIN network (C or- OR gates- EN ter-Aqui TAIN) with, at its head, the Bordeaux University Hospital, ranked first for multi-organ samples from people in good health. Of brain death in France, with 35.7 pieces per million inhabitants, a rate close to that of Spain, the leading donor country in Europe.

Managing an organ and tissue donor is both a long and urgent process: its success is the result of the unwavering involvement of all caregivers and hospital staff. Dr. Q khan provides the best Clinical Consultation in the USA. The nurses of the hospital coordination are entirely dedicated to this and are present, from the reporting of a brain-dead patient to the return of his body to those around him. The interview with relatives, recognized as a caring act, is crucial for their activity.

THE DECREE OF AUGUST 11, 2016, REINFORCING THE PRESUMED CONSENT

On January 1, 2017, the implementation of the decree of August 11, 2016, strengthening presumed consent to organ donation will modify the methods for collecting the testimony of the potential donor.

Currently, relatives can communicate the possible opposition of their deceased to organ donation orally. From now on, in the absence of registration of the latter in the national register of refusals or of a written document signed by him, the detailed testimony of this opposition must be recorded in the medical file of the deceased and co-signed by the close witness. And a member of the hospital coordination or the donor's doctor.

Well-treatment and benevolence being at the heart of everyone's concerns, this legislative development will further strengthen our necessary collaboration to best support these bereaved relatives.

Due to the growing need for grafts which translate into a lengthening of the waiting time for all organs, and because encephalic death (a condition currently required to be eligible for donation) only represents 1% of deaths in hospital, the coming years could be marked by legislative changes allowing organ harvesting to be extended to other types of death, always with due regard for ethics. Again, only close multidisciplinary cooperation will make it possible to carry out these projects.

Organ donation is a chain of life and hope in which every link counts: the completion of the life of one, the donor, will depend on the continuation of the life of the other, the recipient.

ADULT KIDNEY TRANSPLANTATION

The first success of a renal transplant between identical twins was obtained in Boston by the team of Murray and Merrill on December 23, 1954. The surgical technique dates from this time and consists in implanting the kidney in the right or left iliac fossa.

But it is the use of immunosuppressive treatments that help prevent rejection of the transplanted organ and makes transplant success possible. Ten years after a kidney transplant, thanks to current treatments, 63% of kidneys from deceased donors are still functional compared to 78% of kidneys from living donors.

Despite the complications related to long-term immunosuppressive treatments (mainly skin infections and cancers), transplantation is to date the best replacement treatment for end-stage chronic renal failure because it offers patients a better quality of life and better long-term survival than dialysis techniques. In the absence of contraindication, it is provided primarily to any patient with chronic kidney disease progressing to the end-stage.

Kidney transplantation to around

In France, only 45% of patients with end-stage chronic renal failure are transplanted, the majority being treated by hemodialysis or peritoneal dialysis (55%). A shortage of deceased donors explains this lack of referral of patients to kidney transplantation.

In 2015, 4,735 patients were placed on the waiting list against only 3,486 transplants. This deficit has the consequence of increasing the number of patients awaiting a transplant (12,459 currently). The countries of northern Europe can offer kidney transplantation to around 60% of their patients thanks to the development of the transplant from living donors. Doctor Q Khan provides the best Clinical Consultation in the USA.  Given the shortage of deceased donors, the outcome of transplantation from living donors is a significant issue in France.

2015 was a record year for kidney transplantation at Bordeaux University Hospital, with 159 transplants, including 33 from a living donor, which places our center at the forefront at the national level.