Donating your kidney to a sick loved one, a possibility that deserves to be known

It was his wife Marie-Hélène, 52 like him, who immediately volunteered when his doctor asked him, after five months of dialysis, if he had “a living donor” in his entourage.

Renal failure due to a genetic disease, such a transplant presented for him “the most favorable outcome”.

After a battery of medical examinations, the answer came: “we weren’t incompatible and that’s what mattered“, says Ms. Peterson.

Two years after this transplant, her husband has returned to a normal life. For her part, she isthe same as before“.

Since the end of September, the Biomedicine Agency has relaunched a campaign to promote kidney donation between relatives which remains to this day “considered as a solution of last resort“. By doctors who may still be reluctant, but also by relatives and patients who only consider it late.

However, for patients with end-stage chronic renal failure – more than 90,000 patients in France – the benefit of such a transplant is now well established.

Performed for the first time in 1952, this operation opened up new perspectives for patients who had been condemned until now.

“This is the treatment that gives them the best results.“, underlined Monday Michel Tsimaratos, deputy director general of the Agency of biomedicine.

The grafts taken from living donors are indeed “of better quality”: ten years after the transplant, their survival is 76.3% against 61.4% for grafts from deceased donors. Another advantage: the programming of such a transplant, which is not carried out in an emergency, offers more serenity to the recipient.

Extensive blood tests

The risk of rejection is also less than with an anonymous donor.

And the life expectancy for the recipient is extended, while that of the donor is unchanged.

“To donate a kidney during your lifetime, you must be able to justify family or friendly closeness and the desire to perform this gesture.“Which is of course not insignificant, explained Mr. Tsimaratos.

Extensive blood tests are done to check if the donor’s blood and tissues are compatible with those of the transplant candidate.

This was the case of Cyril Savin, 48, who donated a kidney to his little sister Elodie Contentin, 40, in January 2019.

“Other family members weren’t compatible, I was“, he recounted.

For his sister, who lost the use of a kidney after the delivery of her twins, he did not hesitate much but consulted a doctor to whom he was able to ask his “many questions”: “I wanted to know what it was going to bring him and how I was going to live afterwards; there was a bit of stress“, he admits.

“I live exactly as before!“, jokes Christelle Legoupil, 45, who donated a kidney to her 25-year-old little sister, Léa Riera.

“I didn’t think for a second before making this decision.“, she says. But she had to reassure her husband and her three children who were “afraid” for her.

She does not regret anything. “You should still know that the protocol is long, with a whole bunch of exams“, she insists. “We even go through the box + court + to prove that it is a freely consented choice“.

As of November 1, 9,890 patients were on the active waiting list for a kidney transplant. In 2021, there were 3,252 transplants, including 502 from a living donation.

The new bioethics law of August 2021 increased the number of pairs for cross-donation of organs removed from living persons, in order to increase the possibilities of matching between donors and recipients.

The benefits of kidney transplantation with kidney donation between relatives

Like every autumn, the Biomedicine Agency is setting up an awareness-raising system for living kidney donation: “Kidney donation between loved ones: good reasons to talk about it now with your loved ones and your doctor”.

Kidney transplantation is the treatment with the best results in terms of life expectancy and quality of life for patients with end-stage renal failure, especially from a living donor.

Reason n°1: A faster transplant than following a post-mortem donation

The programming of the transplant – except for any emergency insofar as it is carried out early and that it comes from a relative – allows more serenity for the recipient.

Unlike post-mortem donation, there is no waiting list for a kidney transplant between relatives.

Reason #2: Better quality grafts

Ten years after the transplant, the survival of grafts taken from living donors is 76.3% compared to 61.4% for grafts from deceased donors. A transplant from a loved one works better and lasts longer than a transplant from a deceased donor. As health professionals, his role is invaluable in informing recipients, raising awareness among donors and supporting them.

Reason 3: Lower risk of rejection

Kidney transplantation to a loved one, and more particularly between a member of the same family, offers excellent compatibility and above all less heavy anti-rejection treatments.

The rejection reaction against the transplanted kidney is better and better controlled by immunosuppressive drug treatments.

Reason 4: A much better quality of life than with dialysis

Kidney transplantation improves the quality of life of patients compared to replacement dialysis: immunosuppressive treatments are more effective and less restrictive. With the transplant, the patient finds a normal life and can work, go on vacation with a free mind.

Reason #5: Extended life expectancy for the donor

Kidney donation to a loved one avoids a deterioration in their state of health and allows them a better life expectancy. The lives of loved ones are also improved, because the health of the person they care about does not deteriorate and mortality is reduced 5.

Reason 6: An unchanged life expectancy for the donor

The risks during the removal are minimal (the French registry reports no deaths) and life goes perfectly well with only one kidney. The donation does not influence the donor’s life expectancy or lifestyle after the donation. On the psychological level, the consequences of the donation are positive, both on the life expectancy of the donor and on his relationship with his loved one: if it had to be done again, 98.4% of the donors say they want to do it again.

Overview of living kidney donation activity in France and margins of progress

• In 2021 there were 3,252 kidney transplants, including 502 from a living donation (in 2019, before Covid, we were at 3,643 kidney transplants, including 510 from a living donor). This represents 15% of total kidney transplants <20% transplant plan in 2026.
• On November 1, 2022, there were 9,890 registered on the active waiting list for a kidney transplant (8,776 patients on the inactive list).
• Over the first 10 months of the year, +2% for transplants from living donors compared to 2021.