More than 10, 000 seriously ill people, including many children, are currently waiting for a donor organ. For these, it is often the only possible, lifesaving measure. About one-third of patients whose heart, liver or lungs fail will not win the race over time and succumb to their disease before a suitable donor organ is available. Successful transplantation can save lives, but in other cases it can improve the quality of life of sufferers to an otherwise unattainable degree. Anyone who knows the path of suffering of an affected person can imagine what a transplantation means to them - it feels like a new life.
More patients than available donor organs
The gap between available donor organs and patients in urgent need of transplantation continues to widen as more and more patients face a stagnant number of available organs.
Of the approximately 80, 000 dialysis patients, for example, 8, 000 were put on the waiting list for a transplant. Their numbers are almost four times as high as those of organs transplanted per year: in 2017, 1, 921 kidneys were transmitted in Germany. Currently, the average waiting time for a kidney is about six years.
Although about 80 percent of the population is in favor of organ donation, only a few clearly document it with an organ donor card. In 2017, a historic low was reached: Only 797 Germans donated organs after their death (Source: German Foundation for Organ Transplantation).
Successes of transplantation medicine
Meanwhile, the transmission of organs and tissues is the standard of medical care of the population. Nevertheless, these too are usually not without complications. Complex small intestine transmission in particular is a very risky procedure, while kidney transplantation has the highest success rate, with a 1-year survival rate of approximately 90 percent and a 5-year rate of 70 percent, respectively.
Kidney transplants are so successful because kidneys can be kept functional for a relatively long time after removal so that an analysis of the HLA features and reconciliation with the recipient can be made.
With heart, liver, lung and pancreas, the time for this typing is insufficient, so that one has to limit oneself to the blood group analysis. Other factors that influence the success of a transplant are, above all, the health of the recipient.
Organ failure by the body's own defense reaction
The main reason for the organ failure lies in the defensive reactions of the body against the recognized as foreign organ. The rejection must be suppressed from the beginning with medication. Despite this measure, the defense against the graft becomes more and more strong over time, so that the foreign organ can be destroyed. It may be necessary to transplant again.
On the other hand, these drugs reduce the defenses against infections and malignancies or even have organotoxic effects, which can also lead to complications.
Survival and functional rates of organs after transplantation
Below is an overview of the survival and functional rates of the various organs after a transplant has been performed.
|1-year survival rate||5-year survival rate|
|pancreas||40% - 80% (function)||64%|
There are no figures available for the success rate of transplantable tissues, such as parts of the skin, cornea of the eyes, ossicles, heart valves and parts of blood vessels, meninges, bone tissue, cartilage tissue and tendons.
Legal Basis: The Transplantation Act
The Transplantation Act, which came into force on 01.12.1997, regulates the following:
- the donation during his lifetime or after death
- the removal and transfer of organs, parts of organs and tissues to other people
- Preparation of these measures
The aim of the law is the prevention of organ trafficking. Therefore, it also requires a strict separation of responsibilities for organ removal and organ mediation. The German Medical Association creates guidelines:
- to the waiting list and organ mediation
- on investigations to protect the recipient
- for detection of brain death
- for quality assurance
According to this law, an organ donation is also possible if there is no clear will of the deceased, but the relatives can be questioned according to the presumed will (extended consent solution). If these are not available, no organs may be removed.
Organ donor card: relieve relatives
Frequently, the relatives are overwhelmed with this decision, which usually has to be taken as quickly as possible. In view of the psychological burden of the unexpected death of a loved one, it is an understandable reaction.
Also, in order to relieve his neighbor of such failures, everyone should already during his lifetime worry about how to proceed after his demise and this hold in the organ donor card and discuss with family members. Of course, the decision can be changed at any time.
Expiry of an organ donation
Organ donors are usually accident victims with severe brain injury or patients with cerebral hemorrhage who are admitted to an intensive care unit.
In these patients it comes to brain death, that is, to an irreversible failure of all brain functions, under artificial respiration and drug support but not to cardiac arrest. Brain death must be determined independently by two qualified physicians. These doctors must not be involved in organ harvesting or transfer, nor should they be under the direction of a physician involved.
If the deceased has no explanation for organ donation, the relatives are questioned about the presumed will of the deceased. If they decide against an organ donation, the mechanical ventilation is switched off immediately, with an agreement hours after organ removal. In case of unnatural cause of death such as an accident, the corpse must still be released by the prosecutor for burial.
Who organizes the organ transplant?
The intensive care unit informs the German Foundation for Organ Transplantation, which regulates the performance of the necessary tests, the removal of organs and the transport of the organs.
In addition, the Intensive Care Unit teaches the organ mediation center Eurotransplant, which manages the waiting lists for organ recipients in Germany, Austria, the Benelux countries and Slovenia. This will identify appropriate recipients, notify the transplant centers and coordinate the schedule for organ harvesting and transfer.
For organ donation, biological age is crucial
The organ donor card can indicate whether an organ donation is approved or rejected, or whether the decision should be transferred to another person. The donation can be limited to certain organs or it can be explained which organs should not be removed.
The following organs and tissues can be donated:
- Parts of the skin
- the cornea of the eyes
- heart valves
- Parts of the blood vessels, meninges, bone tissue, cartilage tissue and tendons
The risky intestinal transmission is still rarely performed in Germany. The age of the donor is secondary. Important are only the biological age and the functionality of the organs or the tissue, which are determined at the time of removal by the doctor.
Where can I get an organ donor card?
The organ donor card is available free of charge from health insurances, public health offices and many pharmacies and medical practices or can be requested via the telephone number of the Federal Center for Health Education and the German Foundation for Organ Transplantation under the number 0800/90 40 400. This ID card can be printed out on the websites of the Federal Center for Health Education.
Church support: Organ donation as an act of charity
The decision to make his organs available to others after death is also seen and advocated by the church as an act of charity. So you can give even after his death one or more other people the chance of a new life.