Principles and practice of cadaver organ allocation in France

Abstract

In France, as in many other countries around the world, progress in surgical procedures and immunosuppressive therapies, together with the success of transplantation programs, has resulted in an increased need of solid-organ supply [1]. Since most of the patients concerned are suffering from an endstage disease with a life-threatening functional organ failure, organ transplantation is a health-care response which takes place in a tragic context. Facing this need, the procurement of solid organs has been progressively reinforced, but has failed to cover the increase in demand [2, 3]. According to the data gathered by the Etablissement francais des Greffes (EfG), the 2807 solid-organ transplantations performed in France in 1996 are clearly less than the 4982 patients still registered on the national waiting list on 31 December 1995, and even less than the 3785 patients newly registered in the year 1996. Three hundred and forty-seven patients died while awaiting for a graft in 1996, and 740 patients were removed from the waiting list so that 4873 patients were still registered on the waiting list on 31 December 1996 [4].