Health experts have basically welcomed the Federal Government’s draft law on the reform of living kidney donation. In a public hearing of the Health Committee yesterday, Wednesday, as well as in written statements, they praised the initiative as an important step towards being able to help more people in medically critical situations through a kidney transplant. At the same time, they demanded more precise formulations in several places, the deletion of individual regulations and the legal anchoring of a mandatory long-term register to protect donors.

The draft (printed matter 21/3619) is primarily aimed at facilitating cross-living donations – i.e. donations between unrelated or unrelated couples – and thus shortening waiting times for kidney transplants. The German Transplantation Society (DTG) recommended replacing the term “immunological reasons” for incompatibilities between donor and recipient with “medical reasons”. This would also allow anatomical or functional criteria to be taken into account, which would increase the chances of success of crossover and chain donations. In addition, the DTG pleaded for an organ-neutral formulation of the regulations in order to include liver, small intestine or lung donations in the future and not to create kidney exclusivity.

The German Hospital Association (DKG) also called for clearer terminology. The expression “cross-over living kidney donation” used in the draft is intended to create a distinction from the classic donation in the close relationship, but also includes ring or chain donations with several pairs. A more precise delimitation is necessary to avoid misinterpretations.

A central point of criticism of several experts was the protection of donors. Stefan Reuter from the Association of Kidney Transplant Centers of North Rhine-Westphalia called for a legal obligation to have a quality-assured living donor register. This is the only way to collect comprehensive long-term data on medical and psychosocial consequences. The existing German Living Donor Register (SOLKID-GNR) is currently the only nationwide infrastructure for prospective, quality-assured follow-up observations. However, without legal anchoring and mandatory data transmission, this structure cannot be secured in the long term.

A spokeswoman for the National Association of Statutory Health Insurance (GKV-Spitzenverband) emphasized the economic benefit: A kidney transplant is the best form of care for dialysis patients and already saves costs after three years compared to long-term dialysis treatment. The establishment of an intermediary office for cross-donations is complex, but feasible within three years.

Birgit Heilmann, a doctor and kidney donor herself, called for much better information for potential donors about health risks and long-term consequences. The donation of a kidney is a major surgical intervention in the physical integrity of a healthy person. She spoke out in favour of preserving the principle of subsidiarity and rejected anonymous, undirected living donations.

A representative of the Living Kidney Donation Interest Group described practical aftercare problems, such as difficulties in securing it through the accident insurance fund. Many donors are left with insufficient support after the operation.

The hearing served to prepare for further deliberations on the draft law in the Health Committee. The experts agreed that the reform has the potential to strengthen organ donation – provided that donor rights and data security are consistently maintained.

Editor: X-Press Journalistenbüro GbR

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