Article • Transplantation

Organ donation in Germany - the gruelling fight for trust

Whilst Spain has announced a new record for organ donations the number in Germany is stabilising at a ‘low level’. The good news? The number did not fall any further following scandals surrounding the manipulation in the allocation of donor organs.

Report: Sylvia Schulz

In the third year following the transplant scandal no end to the problems is in sight.

Professor Björn Nashan

The German Organ Transplantation Foundation (DSO), the coordination centre for post-mortem organ dona­tions in this country, reports the number of organ donors nationally increased slightly from 1.5% in 2014 to 877 in 2015 – 10.8 donors per one million inhabitants (2014: 10.7) compared to Spain with 39.7 organ donors per one million inhabitants. 

Thus the dramatic decline in willingness to donate halted, for now. Although 1,296 donor organs were available in 2010, the number decreased continuously over fol­lowing years. There are currently around 12,000 patients await donor organs. According to the DSO, the reason for the drastic decline is transplant scandals uncovered in four hospitals – in Göttingen, Regensburg, Munich and Leipzig. They are accused of manipulating patient data and misrepresenting the severity of patients’ conditions to improve their allocation ranking. 

‘In the third year following the transplant scandal no end to the problems is in sight. The legal fol­low-up to the scandal continues at the forefront,’ said Professor Björn Nashan, President of the German Transplant Society (DTG), during the society’s congress a few months ago. Both politicians and the media reacted: A number of fundamental changes to improve transparency and quality assurance have now occurred in transplantation work.

The Transplant Law, which came into effect in August 2012, has been modified several times in the light of the above events of 2013. Along with extended governmental control over transplants, the law also intro­duced a statutory offense to address potential future manipulations. A nationwide transplant register is also envisaged. This law also cre­ated the legal necessity to employ­ment of transplant coordinators, to be employed by all donor hospitals. 

Additionally, the law has intro­duced a formalisation of processes and continuous monitoring, as well as the implementation and expan­sion of quality assurance procedures for organ removal, donor hospitals and transplant centres. 

Living kidney donors have a slight­ly increased risk of developing kid­ney disease or even needing dialysis compared to healthy non-donors. Younger women donating a living kidney are at higher risk of compli­cations during pregnancy. Further effects can be raised blood pres­sure and protein secretion in urine. As German Transplant Law stipu­lates regular medical follow-ups for all living kidney donors, transplant centres offer annual examinations. However, Banas emphasizes: ‘If there were sufficient post mortem organs available we’d only advise living donations in certain people.’


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