Chronic renal failure is a disease that progresses through five stages of increasing severity. At stage 5, the kidney no longer performs its functions and the patient requires a replacement treatment: kidney transplant or dialysis. Thus in France to date 33,700 people have received a kidney transplant and 42,500 are on dialysis.
When possible, a kidney transplant offers a better life expectancy and a better quality of life compared to dialysis. However, it remains limited due to the lack of available grafts: 12,000 people are currently on the national kidney transplant waiting list.
Kidney transplant: too long delays
If the allocation of a graft falls under a scale of points fixed by the regulations, access to the waiting list is left to the discretion of the medical teams. Thus, registration times (median time between 0 and 10 months) or the early registration rate (between 6.5 and 25% of patients are registered before dialysis) vary between regions.
Some patients also have limited access to the waiting list: people over 70 or suffering from diabetesor obesity. According to the findings of the High Authority for Health (HAS), a woman is also 30% less likely to be registered than a man, at equal age, associated illnesses and professional status.
In order to reduce these inequalities and standardize practices, HAS therefore publishes its recommendations. In particular, it proposes to increase early registration, that is to say before the establishment of dialysis, in order to increase the chances to get a transplant but also the chances of success of this transplant. With these new recommendations, the HAS estimates that at least 1,800 people not on the transplant waiting list could access it.
Who can be put on the waiting list?
Any patient under the age of 85 with irreversible stage 4 chronic kidney disease (likely to progress to stage 5 within 12 months) or stage 5, whether on dialysis or not, must be able to access the list if they do not presents no contraindications to the transplant.
The main contraindications identified by the HAS:
- • patient refusal
- • age over 85
- • cancer or hematological malignancy not in remission
- • severe cardiovascular or respiratory disorders
- • unstabilized acute psychiatric disorders or unmonitored chronic psychiatric disorders
- • a alcohol addictionor a drug addiction hard without weaning plan
- • Proven advanced dementia
- • obesity with a body mass index (BMI) greater than 50 kg/m2.
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-1730888646.jpg "Kidney donation while alive: “It was an act of love that I did for my sister”")
