Organ Transplantation

Abstract

It is commonplace to say that the success of transplantation therapies has led inexorably to their generalisation. Far from the experimental nature of the first interventions carried out in the middle of the 20th century, new technologies have produced an increase in survival and a substantial improvement in the quality of life. This new scenario has made transplants a therapeutic alternative that is increasingly demanded and used. Indeed organ transplantations may mean the difference between life and death for hundreds of thousands of people worldwide. No doubt that transplants are often the most cost-effective treatment, and sometimes the only way to treat liver, lung, or heart failure.

However, it should not be forgotten that the transplantation process is characterised by a series of factors that make it different from any other therapy. The most important is the persistent gap between the need for transplants and the availability of organs. The shortage of organs affects all countries. Official figures show that there is no country where the availability of organs is sufficient to meet the existing demand. In the United States, more than 100,000 people are on a waiting list for an organ, but only about 40,000 transplants were performed in 2019. In the case of the European Union, approximately 34,000 transplants were carried out in 2019, while ten patients died every day waiting for a transplant and nearly 60,000 patients remained on the waiting list at the end of the year. The existence of the organ shortage is inevitable, absent breakthroughs in synthetic organs or xenotransplantation.

Furthermore, there is enormous variability in the donation and transplant activity among different countries. The access to transplant therapies for patients varies depending on where they are in the world. These disparities in access reflect factors that are highly complex and sensitive, including legal (type of legislation and consent systems in place in the country), organisational (performance of national transplant programmes and teams), and cultural (such as the awareness in the general population, the health literacy or religious beliefs). Thus, for example, organ transplants are mostly carried out in countries that have reached a certain degree of development and have promoted the implementation of the systems that make them possible.

Still, as indicated, the shortage of organs is a global problem that affects all countries, both those that have implemented effective donation and transplant systems and those that still lack them. Accordingly, in the regulation of organ transplantation, considerable attention is paid to strategies for increasing the organ supply and policies for allocating the organs that are available.

Keywords: organ transplantation, organ allocation, organ donation

JEL Classification: K19