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Despite the Corona pandemic, the German Society for Tissue Transplantation (DGFG) has once again succeeded in further expanding tissue donation and supplying more patients with corneas, heart valves, blood vessels, and amniotic membranes: with the help of the total of 2,897 tissue donations realized, the DGFG was able to provide more than 7,000 patients with a tissue transplant last year, including 4,145 with a cornea. This means that DGFG more than doubled the number of tissues donated for transplantation in the past ten years (2011: 3,143 tissues donated). The pandemic is also apparently ensuring a high level of solidarity among the population: 42 percent agreed to donate tissue. The German federal state with the highest donation rate in 2021 is North Rhine-Westphalia: here, a total of 475 tissue donations were realized.
The Corona pandemic continues to keep the medical world in particular on tenterhooks, but has so far not led to a slump in tissue donation. In the course of the 7,390 informative talks, tissue donation was approved 3,103 times. This translates into a consent rate of 42 percent in 2021, again higher than the previous year (2020: 40.7 %). In total, the clinics reported 44,231 potential tissue donors to the DGFG. Although a large proportion were not eligible for tissue donation for medical reasons such as a COVID-19 infection, the high level of approval among the population nevertheless led to a positive result in the donation figures.
The increased number of people who have already made a decision during their lifetime is also encouraging: 28 percent have already expressed or documented their will to donate tissue during their lifetime in 2021. Ten years ago, this was only 14 percent. If the will is not known, relatives can decide in the deceased’s best intent – in 2021, this was the case in more than two-thirds (69.7 %). The clear call of the DGFG is therefore: Make your decision while you are still alive and communicate it to your relatives. Make your decision clear beyond death!
In contrast to organ donation, tissue donation is not linked to brain death diagnosis. Thus, also in 2021, the majority of tissue donations were realized after cardiovascular arrest (85.7 %). A retrieval of heart valves and vessels is possible up to 36 hours, an eye cornea donation even up to 72 hours after death. In 2021, tissue removal took place after an average of 29 hours from the determination of the time of death.
Organ donation remains important for patient care, particularly with cardiovascular tissue (CVT), i.e., heart valves and blood vessels: a total of 369 tissue donations came from organ donors (12.7 %). In 59 percent of these tissue donations, the heart could be removed for recovery of the still-functioning heart valves and vessels. The demand for these tissues is high. With 154 heart valves allocated, half of all requests could be met in 2021.
The constant expansion of the donation programme throughout Germany, as well as the growing willingness of the population, have led to more than doubling the DGFG’s tissue supply to patients within the last ten years. In order to cope with this high donation volume, 13 tissue banks cooperate in the DGFG network for tissue processing. In total, the tissue banks processed 6,362 incoming donations last year. Despite rising numbers, however, there is still a shortage of tissue in Germany: in 2021, the DGFG was able to timely fulfill 73 percent of all requests for a corneal transplant; for heart valves, the rate was only 50 percent. For patients, every open request means an even longer road, fraught with suffering, to receiving a redemptive transplant.
46 living tissue donations were realized by the DGFG in 2021. Living tissue donation includes the donation of the placenta and its amniotic membrane in the context of a planned cesarean section birth. In ophthalmology, it is used to treat the corneal surface and can be placed on the diseased eye as an AmnioClip-plus similar to a contact lens. In total, the DGFG was able to arrange 2,072 amniotic grafts, including 74 AmnioClip-plus.
Another achievement in 2021 in the DGFG network was the launch of the so-called LaMEK preloaded: The already preloaded corneal lamella, a thin layer of the donor cornea, can be injected by ophthalmologists in a special form of corneal transplantation (DMEK) without any contact. This thin layer is pre-prepared and quality-tested in a tissue bank in the DGFG network, which guarantees a high level of safety for both surgeon and patient. The procurement of the LaMEK preloaded is carried out by the DGFG. The transplantation system was developed together with the Eye Clinic Sulzbach and Geuder AG.
In 2022, the DGFG celebrates its 15th anniversary. From 1997 to 2007, it was still organizing tissue donation as a subsidiary of the German Organ Procurement Organization (DSO) as the Society for Tissue Transplantation (DSO-G). Today, the DGFG benefits from its 25 years of experience in tissue medicine and so do the numerous patients who can be supplied with tissue year after year.