World Kidney Day on March 14, 2024: kidney donation between relatives: real hope for patients waiting for transplants - comuniqué

In France, 62% of transplantation activity involves kidney transplants. Of the 5,634 transplants performed in 2023, 3,525 were kidney transplants, including 557 thanks to a living donation from a close relative.

Today, kidney transplantation is the reference treatment for end-stage chronic kidney disease. Kidney transplants based on the donation of a close relative are the best therapeutic solution for chronic end-stage renal disease. Over 90,000 patients are currently being treated for end-stage renal disease, caused mainly by diabetes and high blood pressure, and these figures are rising every year. However, it is often considered as a last resort after dialysis, even though it is now the most effective treatment and greatly improves the comfort of life for patients suffering from end-stage renal failure.

Eric: "_ I'm a little proud to have done this for my daughter."_ Charlotte: "I was able to have a child. When you have a transplant, you go back to a normal life, there's nothing impossible."

"I've been able to get back to looking for work. I do boxing, badminton and bodybuilding. My future today is first and foremost to keep my kidney, and for that I have a lifestyle that I hope is beyond reproach."

To meet the growing needs of patients, the Agence de la biomédecine is supporting the development of kidney transplants from living donors, to complement donations from deceased individuals. The 2022-2026 ministerial plan for organ and tissue procurement and transplantation has set a target of 20% living-donor transplants by 2026, and we are close to 16% in 2023.

Concrete actions have been taken to encourage kidney donation between relatives:

• a national referral physician for the development of living kidney donation began meeting with transplant teams in 2023;
• new recommendations for good medical practice were published in January 2024;
• an annual awareness-raising campaign for patients, their families and the doctors in charge of their care.

An emergency physician trained in public health, Dr. Durin was commissioned by the Agence de la biomédecine to support France's 33 kidney transplant teams: "France is the third country in the world with the highest number of organ donations per inhabitant from deceased donors, but when it comes to living donation, our country is at the bottom of the Western league table. That's why we meet with all our teams to identify the obstacles to the development of donation activities.

Reason no. 1: Faster transplants than post-mortemtransplants The early scheduling of transplants from a close relative offers the recipient greater peace of mind, with no waiting list, unlike post-mortem transplants.

Reason no. 2: Better-quality transplantsAfter ten years, the survival rate for transplants from living donors is 76.3%, compared with 61.4% for transplants from deceased donors. Healthcare professionals play a decisive role in informing and supporting donors and recipients.

Reason no. 3: Reduced risk of rejectionKidney transplants between close relatives, especially members of the same family, offer excellent compatibility, reducing the need for heavy anti-rejection treatments.

Reason n°4 : Much better quality of life than dialysisKidney transplantation significantly improves quality of life compared with dialysis, offering greater freedom and less strain from immunosuppressive treatments.

Reason n°5 : Longer life expectancy for the patientDonating a kidney to a loved one gives the patient a longer life expectancy and prevents a deterioration in health.

Reason n°6 : Unchanged life expectancy for the donorThe risks involved in kidney donation are minimal overall, and the donor can lead a normal life with just one kidney, with no significant impact on life expectancy. Annual follow-up is scheduled and essential.