Transplant physician’s view point: What is the situation of transplantation in Europe? How are EU countries doing?
By Prof Rainer Oberbauer, Austria. European Society for Organ Transplantation
According to the Global Burden of Disease Network (http://www.healthdata.org/), death due to end stage renal disease rose by about 3% over the last one and a half decades. The epidemiology in the EU 28 countries however is very heterogenous as indicated by the incidence of renal replacement therapy which ranges from below 100 pmp to more than 200 pmp. The vast majority of patients are treated by hemodialysis and only a small fraction receives a kidney transplant.
However, transplantation restores an almost normal quality of life and is at the same time cost effective. Thus it is clear that renal transplantation is underused in Europe and should be promoted and supported. Several strategies exist to increase the donor pool. One of the easiest and most promising is the increase of living kidney donation. In some countries such as the Netherlands every other transplant is performed with a living donation whereas in other such as Croatia or Slovenia almost no living donor transplants are performed. There is a clear political and medical need for support.
The transplant community has achieved great improvement in outcomes over the last two decades. At the end of the last century roughly 10% of grafts failed within the first year. In recent years this rate could be reduced to below 5%. It is expected that further improvements will occur by increasing the number of preemptively transplanted patients and by further research in innovative immunosuppressive concepts or even progress in immunological transplant tolerance induction.
Kidney transplantation is the key to counterbalance the ESRD epidemic we are seeing in Europe. Support from health policy makers will be of utmost importance for the medical transplant community to achieve this goal.
Download Professor Oberbauer presentation slides here.