A 19.3% increase in organ transplants by 2021, thanks to the mobilization and commitment of all professionals in the donation-to-transplant chain.
Published on 12 January 2022
After 2020, a year marked by the start of the Covid-19 epidemic in France, 2021 brought patients and healthcare professionals face to face with the long-term effects of the health crisis. In the field of organ and tissue procurement and transplantation, teams demonstrated their unfailing commitment and resilience throughout the year. The Agence de la biomédecine would like to pay tribute to their strong mobilization and ability to adapt, which led to a 19.3% increase in transplant activity compared with 2020: in 2021, 5,273 transplants were carried out for patients on waiting lists.
Throughout the year, the Agence de la biomédecine has continued its day-to-day work of supporting the identification, procurement and transplantation activities throughout France. In March 2021, in consultation with learned societies, it issued new recommendations on the continuation of procurement and transplantation activities in the context of the Covid-19 epidemic. Widely distributed to organ and tissue procurement coordinators in hospitals, transplant teams, directors of healthcare establishments and regional health agencies, these recommendations have raised awareness among all stakeholders of the importance of maintaining organ procurement and transplantation activities, in view of the national priority conferred on them by law, and of the challenge of preserving the safety of transplant patients in a context where viral circulation exposes them to high risks. Reconciling these two requirements has been at the heart of the concerns of professionals in the donation-to-transplant chain throughout the past year.
In 2021, 5,273 transplants were possible thanks to 1,392 deceased donors and 521 living donors. Compared with 2020, there was a 19.3% increase in the total number of transplants in France. For transplants from living donors, the 2019 level of activity was matched.
| Type of transplant | 2017 | 2018 | 2019 | 2020 | 2021 |------------------------------------------------------------|-----------|-----------|-----------|-----------| | Heart transplants | 467 | 450 | 425 | 370 | 408 | | Heart and lung transplantspulmonary transplants | 6 | 9 | 9 | 8 | 6 | | Lung transplants | 378 | 372 | 384 | 283 | 316 | Liver transplants (of which living donors) | 1 374 (18)| 1 323 (14)| 1 356 (19)| 1 128 (15)| 1 224 (19)| | Kidney transplants (of which living donors) | 3 782 (611)| 3,546 (537)| 3,643 (509)| 2,591 (385)| 3,251 (502)| | | Pancreatic transplants | 96 | 78 | 84 | 34 | 67 | | Intestinal transplants | 2 | 3 | 0 | 3 | 1 | | TOTAL (including living donors) | 6,105 (626)| 5,781 (551)| 5,901 (528)| 4,417 (400)| 5,273 (521)|
2021: a look back at the year's highlights
Frequent exchanges with patient associations to bring health democracy to lifeSet up in 2020 at the initiative of the Agence de la biomédecine, the national committee for monitoring the impact of the Covid-19 epidemic on organ and tissue procurement and transplantation activity continued to meet throughout 2021. Made up of representatives of associations representing transplant patients or patients waiting for a transplant, representatives of transplant professionals, as well as members of the Agence de la biomédecine and representatives of the French Ministry of Solidarity and Health, it adapted the pace of its meetings to the fluctuations of the epidemic. In 2021, 12 meetings were held by videoconference in order to share the information available to the Agence de la biomédecine with all committee members in near-real time, and to respond to the concerns of stakeholders within the Agency's remit. These meetings are ongoing, and the next one will take place on January 14, 2022.
TheAgence de la biomédecine continuously collects data on organ procurement and transplantation activities in France. This database is an invaluable resource for epidemiological monitoring, medical research and therapeutic progress. Over the course of 2021, the Agency has endeavored to make the most exhaustive use possible of the data at its disposal, in the interests of patients and the needs of professionals in the donation-to-transplant chain. As a result, 59 publications were issued in scientific journals, the highest annual number since the Agency was set up.
The first islet transplantIn 2020, the French health authority (Haute Autorité de Santé) issued a favorable opinion on the inclusion of islet transplants on the list of procedures eligible for reimbursement by the French health insurance system. Throughout 2021, work continued with the Agence de la biomédecine to prepare for the implementation of this "routine" transplant. In December 2021, the first islet transplant was carried out at the Lille University Hospital, under an authorization issued a few weeks earlier by the Hauts-de-France Regional Health Agency, following advice from the Agence de la biomédecine. This premiere offers a new perspective of care for patients whose diabetes is difficult to balance, as well as for people living with a kidney transplant.
International dataItaly has recorded an 8.1% increase in the number of organ transplants in 2021 compared with 2020, with 3,717 transplants. Other European countries have not yet communicated their activity figures for 2021.
Epidemiological bulletin on kidney transplant and dialysis patients in FranceAs at January 3, 2022, the Agency counted 12,978 patients infected with SARS-Cov-2: 4,019 kidney transplant patients and 8,959 dialysis patients. As at December 12, 2021, available data indicate that 90.9% of kidney transplant patients had received a first dose of vaccine, and 90.1% a second dose. For dialysis patients, 91.5% have received a first dose and 90.5% a second dose, with significant disparities between departments (source: https://datavaccin-covid.ameli.fr). No information is available to date on the third dose.
Living-donor transplantsDespite the effects of the health crisis in 2021, living-donor transplant activity will be comparable to pre-crisis levels, with 502 transplants performed. In France, 16% of kidney transplants were performed from living donors in 2021, compared with 14% in 2020.
Tissue harvestingIn 2021, cornea harvesting increased by 23% compared with 2020, with 5,674 corneas harvested in 2021 versus 4,615 in 2020. This is 10.4% less than the activity recorded in 2019.
Slight increase in refusal ratePublic opposition to organ donation has risen slightly: the refusal rate stands at 33.6% in 2021, compared with 33% in 2020.
An increase in Maastricht III transplantsTransplants under the Maastricht III protocol rose sharply in 2021, with 217 patients transplants in 2021 versus 151 in 2020, an increase of 43.7%. This increase in the number of retrievals has enabled 552 organ transplants to be carried out, representing 10.5% of the total number of transplants performed in France. In particular, the first islet transplant was carried out under the Maastricht III protocol.
Registration and procurement activity in 2021Despite a 4.5% drop in the number of registered brain-dead patients in 2021, the number of transplants from brain-dead patients has risen by 2.7% compared with 2020, to 1,392 donors. Similarly, the total number of deceased donors harvested in France (also including donors who died of circulatory arrest) has increased by 6.61% in 2021 compared with 2020, thanks to the commitment of hospital coordination and resuscitation teams.
"The 19.3% increase in the number of transplants carried out in 2021 compared with 2020 is the fruit of the commitment of all the professionals involved in the donation-to-transplant chain, as well as proof of the resilience of this very special sector. Agence de la biomédecine*will continue to mobilize in 2022 to support organ procurement and transplantation, while adapting its action to the evolution of the Covid-19 epidemic".*Madame Cortot-Boucher, Chief Executive Officer of Agence de la biomédecine.
PRPA press contacts for Agence de la biomédecine Danielle Maloubier: danielle.maloubier@prpa.fr / 06 24 26 57 90 Isabelle Closet: isabelle.closet@prpa.fr / 06 28 01 19 76