[Outcome and outlook of living donor kidney transplantation activity in France].
ABSTRACT In France, the bioethic law of 2004 authorized the extension of the living donor (LD) pool to members of the extended family and any person justifying of a 2 year-long relationship. The number of living donor kidney transplantation (LDKT) increased until reaching a maximum of 246 grafts in 2006 (9% of total activity). Two years later, in 2008, LKG activity slowed down to 7.6% of the total activity (222 grafts).
We analyzed all LDKT carried out in France since 2000 according to various indicators. In addition, a questionnaire was sent to renal transplant teams in order to identify potential causes for the decrease in LKG observed in France.
From 2000 to 2006, over 1400 LDKT were performed in France. However, donor to recipient relations show that the large increase observed in 2006 was not linked to the extension of the LD pool. LDKT activity then started decreasing as soon as 2007. The questionnaire was sent back by 40/44 (91%) renal transplant teams. Their answers led to the identification of potential constrain impacting LDKT activity in France. Among these obstacles: workload and time-consuming to prepare the transplantation and the donor, ethical constrains and lack of appropriate communication and information delivered to the professionals.
The important increase in LKG activity in 2006 is not clearly understood. However, several approaches to develop the activity in the next years have been identified.
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ABSTRACT: The Haute Autorité de santé, in association with the Agence de la biomédecine, realizes, at the request of the Caisse nationale d'assurance maladie des travailleurs salariés and the Direction générale de l'offre de soins, a medical economic evaluation on treatment's alternative of terminal chronic renal insufficiency. To answer at this request, a multiannual working program was set up. A first part of this work concerned specifically the development of the kidney transplant. Indeed, the kidney transplant occupies a particular place among the various modalities of treatment of the terminal chronic renal insufficiency because it is at the same time the most effective on a medical plan and the least expensive, thus the most efficient. However, its development is constraint by the lack of the transplants and the number of patients registered on the national list of wait increases every year. The objective of this article is to present the method of work as well as the main identified axes of development.NÃ©phrologie & ThÃ©rapeutique 04/2014; · 0.50 Impact Factor
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ABSTRACT: Successful organ transplantation relies on several ancillary activities such as the identification of a compatible donor, organ allocation and procurement and the coordination of the transplant process. No existing study of the overall costs, in France, of these additional transplantation activities could be identified. This study determines the total additional costs of ancillary transplantation activities by comparing the costs of kidney transplantations with living donors against those using deceased donors. The data used are drawn from the 2013 public healthcare tariff calculations, PMSI recorded activity and transplant activity in 2012 as assessed and reported by the Agence de la biomédecine. The results show that, in 2012, additional transplant costs varied from 13835.44 € to 20050.67 € for a deceased donor and were 13601.66 € for a living donor. In conclusion, this study demonstrates that all the costs covered by National Health Insurance need to be taken into account in the economic impact evaluation of renal transplantation and during the development of this national priority activity.Nephrologie & therapeutique. 06/2014;
- NÃ©phrologie & ThÃ©rapeutique 10/2013; · 0.50 Impact Factor