The Most Sought-After Organ: Kidneys in Germany, Then and Now
Most Demanded Organ in Germany Demand Outpaces Supply
Currently, over 2000 kidneys are transplanted annually in Germany, yet more than 6000 people are on the waiting list. Bettina Lange, a resident of Brandenburg's Brieselang, is hopeful about her husband's kidney that she received in 2009, as she was battling kidney disease for decades.
This treatment is collectively referred to as dialysis, a process that began nearly 80 years ago in the Netherlands. Over 100,000 people in Germany undergo this lifesaving procedure permanently. However, despite the frequent dialysis sessions, the health of patients gradually deteriorates, necessitating a foreign kidney.
First Transplant: A Small Step for Mankind, a Giant Leap for Medicine
On June 17, 1950, the world witnessed the first successful kidney transplant between two humans, carried out in a small US hospital. The 44-year-old recipient received a kidney from a deceased donor, but the organ was removed after ten months due to rejection. However, this groundbreaking operation laid the foundation for future advancements in organ transplantation.
Germany followed suit in 1963 with the first successful transplant, and since then, over 100,000 kidneys have found new homes in the country. Some kidneys come from living donors, whereas most are obtained from deceased donors.
Finding a New Kidney
A healthy partner, relative, or loved one often steps up to donate a kidney. This was the case for Bettina Lange, as well as for the Federal President, Frank-Walter Steinmeier, who donated his kidney to his wife in 2010.
While the donor goes through regular check-ups after the surgery, their kidney function remains about 70 percent of the original level, allowing them to lead a relatively normal life. Recipients must strictly adhere to their diet and medication schedules to prevent rejection and minimize infection risk.
The Organ Donation Conundrum
Germany, in comparison to European countries like Portugal and Spain, has a lower willingness to donate organs due to factors such as legal frameworks, cultural attitudes, and public awareness.
Many countries, including Spain (since 2010) and Portugal (since 2016), have implemented opt-out donation systems, where every individual is considered a potential donor unless they explicitly opt out. These systems have resulted in higher donation rates. Conversely, Germany continues to rely on an opt-in system, where individuals must actively consent to becoming donors, leading to a comparatively lower donation rate.
Public awareness campaigns and education efforts can significantly impact the willingness to donate organs. Countries with more effective campaigns often experience higher donation rates. Unfortunately, Germany lags behind in this area, contributing to the shortage of volunteers and ultimately the long waiting times.
Despite the persistent shortage, almost 6,400 patients were waiting for a new kidney at the end of 2024, with the waiting time between starting dialysis and surgery averaging seven years for those aged 18 to 64[3]. However, there are more organs available for the elderly, even though these transplants tend to have shorter lifespans.
In essence, the difference in organ donation willingness between Germany and countries like Spain and Portugal can be attributed to differences in legal frameworks, cultural attitudes, healthcare infrastructure, and public awareness campaigns. By adopting opt-out systems and improving public education, Germany could potentially increase its donation rate and alleviate the pressure on the waiting list.
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