The number of organ transplants in the country is substantially falling. Kidney, liver, heart and pancreas transplants reported the biggest drop last year. With liver transplant numbers, the decrease is the largest since 2002 despite the stable number of applicants for a transplant. All evidence suggests the reason to be the ageing of the population but also people’s unwillingness to donate.
Last year, 357 people underwent a kidney transplant, which is the lowest number since 2002. It was 12 years ago when doctors carried out their record number of 445 kidney transplants. The data comes from a publication on the health care in the country in 2009 by the Institute of Health Information and Statistics of the Czech Republic.
The reasons for the falling numbers of transplants are multifold: “The population is ageing. People are – also due to rising life expectancy – more ill and, so, not every potential donor is suitable,” the director of the Czech Transplantations Coordinating Center Pavel Březovský says.
He also mentions another reason: “The care for patients with intracranial bleeding has notably improved. The sort of cases that ended with a death in the past today survive conditions that used to be irreconcilable with life,” he explained.
For this very reason, there are less deceased donors as their organs can’t be used for transplant purposes. Transplanting in such cases could lead to a transmission of infection, endangering the organ recipient’s health. It’s good news, indeed, but only halfway: medicine is progressing, but on the other hand, some patients might not live to receive the needed medical help.
Perpetual lack of organs
The fact is – and poignant it is – that there is a lack of organs. “Like in the Czech Republic, in all countries where transplants are carried out, the demand will top the offer,” Březovský said.
Luboš Olejár, president of the Czech Association of Patients, blames the public’s reluctance for the falling number of transplant procedures. “The offer as well as the exchange of transplants might be held back by the dwindling willingness of family members left behind as well as of living donors to do something for a stranger,” Olejár says and points his finger to officials. “Some administrative interventions by the Health Ministry and probably also the ‘investigations’ by insurance companies have an adverse effect,” he said.
Dialysis helps patients, but they often have to undergo a transplant anyway. In the Czech Republic, about 400 kidney transplants happen each year. Nine out of 10 donated kidneys come from deceased donors, of whom about 60% die due to disease and the rest due to an injury. Only in 20 to 30 cases a year, the donors are alive. And almost always they are family relatives. Cases of a “stranger” –generally, a friend—donating can be counted on the fingers of one hand.
On average, the waiting period for a kidney transplant is a year, and so has it been for a few years now. In other developed countries—for instance in Germany—it’s three years and stretching.
Despite the bleak data on kidney transplants, the Czech Republic might be headed for a brighter future. “We’ve made progress this year—by the end of the year, the number of kidney transplants should surpass the number in 2007, the most successful year so far,” Březovský promises.
Heart, liver and pancreas are all down
Apart from kidney transplants, the number of heart transplants also decreased. Last year, 69 operations were carried out; this year 10 fewer. It’s a similar story with the liver. Heart surgery also reports a substantial drop in surgeries compared to previous years. Between 2003 and 2004, 11,000 heart transplants were carried out; last year, only 8,551 (the statistic is a pre-estimate). Diseases of the circulatory system, however, are the No 1 killer in the country. Last year, 52,280 people succumbed to them.
The dismal statistics are only redeemed by lung transplants. Last year, doctors carried out 20, a record amount since 1997.