A Life-Changer: The Most Transplanted Organ in Germany
Critical organ demand highest in Germany
In Germany, over 2000 kidney transplants are carried out annually, yet more than 6000 people wait for their turn on the list. Bettina Lange, a resident of Brandenburg's Brieselang, is one such individual who found a glimmer of hope in the form of her husband's kidney.
A dialysis patient prior to the transplant, Lange shared her struggle, "I didn't feel well on dialysis, sometimes very poorly." Kidney transplantation offers a lifeline for many who endure the exhausting three-times-weekly sessions under medical supervision. However, this procedure only partially replaces the body's natural function, so health gradually deteriorates for those waiting for a foreign kidney.
The Dawn of Kidney Transplantation
The journey of kidney transplants began worldwide on June 17, 1950. The US saw the first successful human kidney transplant in a small Chicago hospital when surgeon Richard H. Lawler transplanted a deceased donor's organ to a 44-year-old patient in a forty-five-minute operation. Despite initial success, the organ had to be removed after ten months due to rejection.
The first such procedure in Germany took place six years later in 1963 when researchers Wilhelm Brosig and Reinhold Nagel transplanted an organ into a 21-year-old. Tragically, she passed away a few days later, but six months later, the same team achieved the first long-term success with a 25-year-old who received a donation from her mother [4].
How Patients Acquire a New Kidney
There are two primary sources of kidneys for patients – deceased or living donors. Bettina Lange and Federal President Frank-Walter Steinmeier are examples of living donors who volunteered to improve another's life. Pre-operation preparation is essential to ensure the compatibility of the donated organ with the recipient's body [2].
Recipients must adhere to strict immunosuppressive medications and lifestyle changes, such as diet adjustments and avoidance of potential kidney irritants, to prevent rejection and ensure proper organ function [5]. While regular health check-ups are required, many healthy donors can continue with their previous lives post-transplantation with around 70% of their original kidney function [3].
The Donor Dilemma
The shortage of donors has persisted for decades in Germany, with donation-readiness rates disappointingly low. In 2024, only 953 deceased donors led to 2855 organs being removed, including 1391 kidneys [2]. Germany ranks lower in European comparison for donor density, with Portugal's value being approximately three times higher, and Spain's considerably higher [6].
Through the Eurotransplant intermediary, which includes eight European countries, Germany receives more transplants than it contributes. Patients may face extended waiting times, with nearly 6,400 individuals waiting for a new kidney at the end of 2024 [2]. The current system, which requires explicit consent for organ removal, may contribute to the organ shortage.
A Look to the Future – Opt-Out Systems and Progress in Transplantation
Introducing an opt-out system, where everyone is considered a donor unless they explicitly opt-out, is a suggested solution to address the organ shortage. Germany's past experience with an opt-out system in East German clinics after reunification shows its potential [5]. By ensuring a consistent organ supply and reducing waiting times, such a change could significantly impact kidney transplantation in Germany.
As our understanding of immunology and organ transplantation deepens, new treatments and techniques might soon provide even more favorable outcomes for those waiting for a second chance at life.
- The community policy in regards to organ donation should emphasize the importance of addressing the shortage of kidneys, especially in light of the over 6000 individuals waiting for a transplant in Germany.
- As science and medical-conditions advance, there is a growing need for vocational training programs in the field of vocational training for healthcare professionals, including those specializing in chronic-diseases management and transplantation therapies and treatments.
- For someone like Bettina Lange, who has chronic-kidney-disease, health-and-wellness encompasses not only fitness-and-exercise and mental-health therapies but also proper nutrition and potential alternative treatments such as CBD.
- In space-and-astronomy, research on the effects of zero gravity on human organs could pave the way for breakthroughs in organ transplantation and prolong the lives of those suffering from chronic diseases.
- Nutritionists and dietitians play a crucial role in kidney transplantation, educating patients on nutritional needs to maintain a healthy kidney and prevent rejection.
- The future of kidney transplantation lies in the implementation of opt-out systems, such as those adopted in some European countries, to increase the supply of organs and reduce waiting times for life-saving procedures.
