On the occasion of the National Day of Reflection on Organ Donation and Transplantation, June 22, it is time to face a reality that we can no longer consider inevitable: in France, women and men are still dying on the waiting list, because they did not receive the organ that could have saved them in time.
In my field, liver transplantation, this observation is old, documented, recurring: the demand for grafts is growing faster than the number of available organs. Concretely, only one liver is today available for two to three patients awaiting a transplant.
Faced with this serious situation, we have no right to wait. We must of course increase the number of donors, and make organ donation a subject better understood, better shared, better accepted in society. But we must also act on the other end of the chain: better preserve donated organs, better evaluate them, better use them, so that no graft likely to save a life is discarded too quickly.
Respond to a medical emergency
It is this responsibility that we wanted to take on with the graft nursery, inaugurated Monday June 15 at the Pitié-Salpêtrière hospital, in the heart of a transplant operating theater.
This is not a technological showcase, but a concrete response to a medical and human emergency. It is the culmination of more than ten years of research, with a simple idea: no longer consider an organ as definitively “usable” or “unusable”, but provide ourselves with the scientific means to understand its real potential and, when possible, to restore it before transplantation.
The next revolution in transplantation isn’t just about finding more organs. It consists of giving grafts a second chance thanks to perfusion, so as to no longer lose those which can still save a life.
Without donor, no graft
Each year, around 300 liver grafts are discarded because their condition does not allow safe implantation: livers that are too fatty, too old, too fragile. The ambition of the perfusion, and therefore of the nursery, is to save at least half of them.
Behind these figures, it is not only a question of technical progress. These are patients who could be transplanted, families who could regain perspective, lives that could be saved.
But this ambition will only make sense if society follows. Because no machine, no technology, no hospital innovation will ever replace the first gesture: the donation. Without a donor, there is no graft to preserve. Without a graft, there is no nursery possible. Without clear words around donation, too many families will continue to discover this issue urgently, at the most painful moment.
A declining practice
However, the refusal of organ donation is progressing. It now reaches nearly 38% across the entire country, and exceeds 54% in certain regions, notably in Île-de-France. Each additional point of refusal corresponds to approximately 100 fewer transplants.
These figures should wake us up. Organ donation remains one of the greatest chains of solidarity that our society has been able to build. Each donor can save several patients, each family who respects this wish directly contributes to reducing the mortality of patients waiting for a transplant.
We must therefore say it clearly: we need a collective start. Talking about organ donation to loved ones is not a secondary subject. It is a civic act, a decision that could, one day, save several lives.
This mobilization must now continue at all levels. By citizens, first, by making their position on organ donation known. By public authorities, then, by supporting the deployment of technologies in large regional transplant centers. By the public hospital, finally, by maintaining control of these innovations.
An issue of health sovereignty
This support is essential to preserve what is the basis of our model: an organ resulting from a donation cannot become the object of commercial logic. Medical innovation must remain at the service of patients and not financial logic. Our health sovereignty will also be measured by our collective capacity to master the tools that will save more lives.
The graft nursery inaugurated in Paris today constitutes proof of concept. Tomorrow, it must be able to be deployed in large regional transplant centers, so that this progress benefits as many people as possible, throughout the country. France has the means to save more lives. It must now fully embrace the ambition.
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