Organ and tissue donation: mobilization more necessary than ever - 22nd National Day of Reflection on Organ Donation and Transplantation and Recognition of Donors, June 22, 2022

In 2019, procurement and transplantation activity had seen an encouraging rise of 1.6% compared with 2018, with 5,897 transplants. In 2020, with the restrictions imposed by Covid-19 and despite the tireless commitment of healthcare professionals, activity fell by -25%, with 4,417 transplants performed. In March 2021, in consultation with learned societies and patient associations, the Agence de la biomédecine issued recommendations to support the continuation of harvesting and transplantation activities in the context of the Covid-19 epidemic. Thanks to the strong mobilization of healthcare professionals and their ability to adapt, activity has picked up again in 2021, with 5,276 transplants performed, an increase of 19.3% on the previous year.

Organ and tissue procurement and transplantation is a "national priority", under the terms of an express legislative provision in the French Public Health Code. The fourth ministerial plan for organ and tissue procurement and transplantation, drawn up in partnership with all stakeholders (institutional partners, learned societies, patient associations and healthcare professionals), provides for unprecedented resources to benefit the sector. Additional funding of 210 million euros has been earmarked over 5 years, bringing the total national contribution to organ and tissue procurement and transplantation to 2 billion euros over the life of the plan. The plan also includes a number of innovative measures and priorities, including the maintenance of appropriate communications.

Since 2017, we are all presumed organ and tissue donors, unless we have expressed our refusal to donate during our lifetime (either by informing our loved ones, or by registering on the national refusal register). While recent communication campaigns have significantly increased awareness of the law (5 years after its adoption, 31% of French people claim to be well informed about organ and tissue donation), the Agence de la biomédecine's priority remains to mobilize and educate the public. That's why the Dons d'organes, un lien qui nous un tous (Organ donation, a bond that unites us all) campaign, which has received very favorable endorsement and incentive scores (89% of those exposed think it's "a good way to broach the subject of organ donation", 27% that it's "likely to change the behavior of those around them" and 17% feel "more concerned about organ donation after having seen the campaign"), will be rebroadcast in the media from June 22 and throughout the summer of 2022.

A filmShowcasing the chain of actors who mobilize to save lives through donation, this film shows, in a very realistic way, how hope can be born even when the worst happens: The Film "Why?

Two postersThe slogan "Organ donation, a bond that unites us all" comes to life in print and out-of-home thanks to two visuals designed in its image: two hands helping each other and a stylized heart, both delicately embroidered. The choice of embroidery, a poetic translation of the message, helps to materialize the bond that is forged between all. The message of the law is also present, to help raise awareness of it among target audiences.

Digital mobilizationIn addition to the hashtag #UnLienQuiNousUnitTous and numerous social network activities designed to engage Internet users, the Agence de la biomédecine is also renewing its partnership this year with a Facebook community that unites over 1 million users around the values of mutual aid and generosity: Wanted Community.

Even with the legal framework in place, the subjectofconsent to organ donation is a painful one when raised at the time of death. Before considering organ and tissue donation, the medical team checks whether the deceased was registered on the national register of refusals and, if not, consults the family. Faced with hospital coordination teams, family members may have a feeling of doubt: if they know and can respect the deceased's wishes with certainty, that's one less pain. Saying what you want about organ donation while you're still alive avoids adding a difficult questioning process for loved ones to the suffering caused by bereavement.

**Paying tribute to donors ** June 22 is also an important day for paying tribute to donors and their families. These men and women who, through their donation, have been able to save patients awaiting transplants. In France, more than 66,000 people live thanks to a transplanted organ.

**There is no age limit for donating or receiving organs.**People over 60 can rarely donate their hearts, but kidneys and livers can be taken from much older people. The only thing that counts is the condition of the organs, which depends very much on the conditions in which the person died and their lifestyle. The average age of donors is rising (57 in 2020, 59 in 2021), not least because older people can have access to transplants (average age 44 in 2000, 53 in 2021).

Respecting the body and returning it to the familyThe removal of organs and tissues is a surgical procedure performed with the same care as on a living person. Incisions are closed and covered with dressings, and if necessary, artificial prostheses are fitted to ensure that the body's appearance remains unchanged. Once the operation has been completed, the body is dressed and returned to the family, who can arrange the funeral of their choice. The cost of restoring the body is borne by the establishment that took care of the removal. On the other hand, the family is responsible for funeral and conservation care.

By law, we are all organ donorsSince 1976, French law has stipulated that we are all organ donors when we die, unless we have expressed our refusal to donate during our lifetime (either by registering on the national refusal register, or by informing our next of kin). It is possible to donate only certain organs and tissues. To do so, you must specify on the national refusal register, or inform your next of kin, which organs and tissues are not to be harvested. Finally, nothing is irrevocable: a person who has registered on the refusal register can go back on his or her decision at any time and modify his or her wishes.

The donor card no longer existsIn France, there is no legally valid donor card. If a person wishes to make known his or her opposition to organ and tissue donation after death, the principal means is to register on the national refusal register, or to make his or her opposition known to his or her next of kin. At the time of death, they will have to attest this to the medical team.

Agence de la biomédecine press contacts Isabelle Closet - Isabelle.closet@prpa.fr / Tel: 06 28 01 19 76 Chloé Pascal - chloe.pascal@prpa.fr www.dondorganes.fr