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.’
07.08.2017
