Why is it good to talk about it

France has defined a new organ and tissue donation plan of 210 million euros for 2022 – 2026, announced on March 14. The objective is to perform 40% more transplants by 2026, i.e. a total of between 6,760 and 8,530 per year.

To understand how the system works in France, we spoke to organ transplant coordinator Samantha Alexander, who left her job as a nurse in England to move to Var in southern France 13 years ago. years.

She accepted a job in the intensive care unit (ICU) of the Dracénie Hospital Center in Draguignan and then became a transplant coordinator, alongside her work in intensive care.

“It’s hard work. When there’s an organ donation, I can be in the hospital for 36 to 48 hours. It’s stressful and emotional,” she said.

“But the next day, when you know that an organ was transplanted into someone else and they were saved, it’s a great feeling.”

In 2021, 5,273 organ transplants were performed in France, from 1,392 deceased and 521 living donors. This is a 19.3% increase from 2020, when donations were heavily impacted by the coronavirus pandemic.

“My colleague and I have been redeployed to intensive care for months to deal with the sudden influx of patients. The activity of the coordination team has therefore been suspended, the operating theaters have been closed and nurse anesthetists are came to help with intensive care.

Read more: Can I donate my body to science after my death in France?

“The agency responsible for arranging transplants has suspended non-emergency kidney transplants and tissue transplants for seven weeks,” Ms Alexander said.

The pandemic has had other impacts.

National periods confinement meant fewer road accidents, so fewer donors. Also, anyone who died who tested positive for Covid could not be considered a donor.

“There’s an enormous amount of testing that happens, in addition to a very careful review of the patient’s medical history,” Ms Alexander said.

“But on the other end of that, there’s someone desperately waiting for, maybe, a new heart.” At any time, there are around 26,000 people waiting for organ donation in France.

Some 900 people die each year because they don’t receive a transplant.

These are usually people who are in dire need, such as those who need a transplant within 48 hours, whether it’s a heart, lungs or sometimes a liver, Ms Alexander said.

The main people on the waiting list are those who need kidneys.

When a person dies with organs or tissue that may be useful, Ms. Alexander contacts the family.

“We want to know if the person may have talked about wanting to donate their organs. We sometimes have three, four, five interviews with them.

“We ask what kind of person their parent was. Were they generous?

“And, of course, we respect the wishes of the person and their family.” France has an “opt-out” system for organ donation, and very few people opt out of the list.

However, the percentage of refusal by relatives of the dead is still high, at 33.6%, despite the number of people waiting for a transplant.

“As a coordinator, if the person is declared brain dead (for organs) or their heart has stopped (for tissues), I automatically ask their relatives if they had spoken about the donation of organs and tissues and whether the deceased was against it,” says Ms. Alexandre.

“Some people know the answer, but a lot of people haven’t discussed it and so the family has to make that decision, which leads to a high rate of rejection. A phrase I hear all the time is ‘We don’t. We never spoke then, just in case, I would say no.” Ms Alexander said that for anyone residing in France, it is extremely important to discuss their thoughts on organ donation with their family and loved ones so that their wishes are known in case their organs or tissues could be used to save another person’s life.

“The heart and lungs need to be transplanted very quickly, in about four hours,” she said, emphasizing the urgency required in this situation.

Read more: Is the ban on blood donation imposed by France on people who were in the United Kingdom justified?

She added that anyone could potentially end up donating vital or life-changing organs or tissue upon death, as each organ is assessed individually. Donors provided livers and kidneys at age 90, or corneas at age 100.

“Hearts and lungs are usually from younger patients, but every organ is examined thoroughly,” she said.

Ms Alexander said it was not as difficult as many might assume to transition from working in a hospital in England to one in France.

The big challenge was overcoming the language barrier, she said.

“When I moved, I already spoke French but not much in terms of medical vocabulary. But it was enough to get by in intensive care, and then it got better. The work was basically the same, the doctors the same.

“Everyone is just trying to do their best for the patients who come in.”

She says her job, despite all its challenges, is ultimately rewarding.

“It can be emotionally draining – being in intensive care is exhausting enough – but over time you think it’s a gift for someone else.

“For families who have lost loved ones, when their organs are donated and someone else benefits, it can be uplifting.

“When younger people die and they donate their organs, it can often be a great comfort to the family, knowing that that person has helped someone else, even after death.”

If you have any questions about organ donation in France, we will be happy to pass them on to Ms. Alexander. Please send an e-mail to news@connexionfrance.com

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