ERCPA Statement on the occasion of the European Day for Organ Donation & Transplantation

ERCPA’s members welcome EU legislation on organ donation and transplantation, which has already resulted in recent years in the development of living-donor programmes in some Member States, as well as improvements in the organisational models (including quality-improvement programmes, communication aspects, and the evaluation of post-transplant results). We call on the Commission to further act in this field, as well as secure EU funding for its continued success.

ERCPA’s members fully share the view of the EU institutions that the main priority in organ donations and transplantation is finding an answer to the shortage of organs. We also agree with the Commission that kidney transplantation is the most cost-effective and best treatment for end-stage renal failure patients. However, it is important to remember that a number of CKD (chronic kidney disease) patients are not suitable candidates for transplantation. Some of the contraindications might be related to the patient’s advanced age, a medical condition which excludes undergoing surgery, malignancy, viral infection, or a condition that excludes intake of anti-rejection medication which is part of the post-transplant treatment. Nevertheless, patients’ transplant referral should always be assessed on case-by-case bases.

We would also like to call on the EU institutions to promote management of care pathways that optimise both pre- and post-transplant states.

ERCPA’s members have identified three areas which they strongly endorse:

1. Increase the number of organ donations

One possibility to raise the number of organ donations across Europe is to increase the number of countries with an opt-out process, as has been implemented in Austria and Wales. All individuals are automatically listed as potential organ donors unless they “opt out,” i.e.: anyone who has not otherwise refused is considered a donor. Opt-out legislation dramatically increases the effective rates of consent for donation. However, in most countries in the EU, the opt-in method is employed, which leads to a far smaller number of organ donations, because people actively have to give their consent to donating. ERCPA members are in favour of the opt-out method, which would greatly increase the number of organs for donation.

2. Increase the transparency of transplant lists

Receiving a kidney transplant is akin to receiving a new lease on life for renal patients. It increases the independence and quality-of-life of renal patients. The renal care providers represented by ERCPA thus see an ethical responsibility to support the viable and correct process of organ donation and transplantation for the benefit of renal patients. One of the key concerns of ERCPA’s members is the transparency of kidney transplant waiting lists. Any patient, who has been found eligible to receive a kidney transplant, will be put on this list and the processing of this list will be closely monitored by the provider.

3. Provide best treatment pre- and post-transplant

Providing the best medical treatment for pre- and post-transplant patients is also a key concern. Of course, the training and development of medical staff ensures that patients receive the best quality of treatment, regardless of the public/private status of the renal care provider. Both private and public providers have a responsibility to ensure the best medical treatment, and handling of transplant patients, pre- and post-transplant. Therefore, ERCPA’s members call for pan-European quality-of-treatment evidence based on data, for all providers, with consequences for those who provide low-quality services.