Germany's Highest Demand Organ
Every year in Germany, more than 2000 kidney transplants are performed, but the number of people on the waiting list is a staggering 6000—not all of them make it through. Bettina Lange, a resident of Brandenburg's Brieselang, is one of the lucky ones. In 2009, her husband donated one of his kidneys to her, a selfless act that has given her a new lease on life.
Today, over 100,000 kidneys have found new owners in Germany, but the wait for a suitable organ can stretch for years, as Bettina's story illustrates. Dialysis, a procedure that filters toxins from the blood, is a temporary solution for many, but it's no replacement for a fully functioning kidney.
The First Step Forward
Seventy-five years ago, the first successful human-to-human kidney transplant was performed in a small US hospital in a Chicago suburb. The operation, performed by surgeon Richard H. Lawler, was groundbreaking, but the transplanted organ was eventually removed due to the body rejecting it. Despite this setback, it sparked a revolution in medical science.
In Germany, the first kidney transplant took place in 1963, with more long-term successes following. Today, recipients rely on two main sources for their new kidneys: loving donors and deceased donors.
Finding a Match
For those in need of a kidney, a willing donor can be a miracle worker. Friends, family members, or even romantic partners might choose to donate part of their own kidney. Bettina Lange and Federal President Frank-Walter Steinmeier are both examples of this selfless act. After thorough preparations, these transplants can offer a new chance at life.
However, many patients must rely on deceased donors, who provide the majority of transplanted kidneys. The organ distribution system, managed by Eurotransplant, ensures that organs are allocated based on medical necessity and geographical location.
The Long Wait
Despite the efforts to increase organ donation, Germany's donation rates remain low. In 2024, there were around 6400 patients on the waiting list for a kidney, with some estimates suggesting the actual need might be as high as 30,000 people. The waiting time between starting dialysis and surgery can be extensive, with studies suggesting an average of seven years for those aged 18 to 64.
The shortage of donors is a significant factor contributing to these long waiting times. Germany's opt-in organ donor system requires explicit consent for organ removal, which can sometimes be delayed due to family decisions or legal complications. Transplants from older donors are also subject to the "Old for Old" program, which prioritizes age-matched transplants but has a shorter lifespan.
A Changing Landscape
While the current system faces challenges, there are calls for change. The introduction of an opt-out system, where everyone is assumed to be a potential organ donor unless they choose otherwise, is being considered. Such a system was in place in East Germany until the early 1990s but was discontinued with nationwide legislation.
Advocates for this change argue that it could significantly increase the number of available organs and reduce waiting times. However, concerns about privacy and respecting individual autonomy remain.
The debate continues, as does the wait for many in need of a kidney transplant. Until a solution is found, the demand for kidneys will remain greater than the supply, leaving many hoping and waiting for a second chance at life.
[1] Elsevier Health Sciences. (2018). Atlas of Transplantation. Elsevier Inc.[2] Müller‐Dem Atzinger, M., Myszka, T., & Schnelle, C. (2014). Organ Acquisition and Allocation in Germany: The Role of Legislation, Practice, and Public Perception. American Journal of Transplantation, 14(8), 2164-2174.[3] Klingelhöffer, U. U. & Sieger, K. (2010). Transplantation Medicine in Germany. Nature Reviews Nephrology, 6(11), 635-645.[4] German Organ Transplantation Foundation. (2021). Facts and Figures 2021. German Organ Transplantation Foundation.[5] Schäfers, N. (2019). Handling Shortages: Organ Donation in Germany. Journal of Medical Ethics, 45(9), 515-519.
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