[Living-donor kidney transplantation in the European countries and in North America (2001-2009)]. / Comparaison de l'activité de greffe rénale à partir de donneur vivant en Europe et en Amérique du Nord (2001-2009).

In front of kidney transplants shortage, the alternative of living donor renal transplantation is discussed. The purpose of this work is to compare, in 16 European countries and of North America having a consequent activity, the levels of living donor renal transplantation activities and their possible impact on kidney shortage, usually reported in a fragmented and punctual way. In 2009 and in spite of a light growth, the French rate of 3,5 living donor kidney transplantation per million people (pmp) was one of the weakest just before Italy and Finland. Numerous countries exceeded the rate of 14 pmp. Others as Spain and Portugal know a regular growth while their transplant activity was mainly based on brain dead donor. This growth is also observed in Germany and in Austria. France, in spite of an increase of kidney transplantation activity, had a high level of kidney shortage (2,7 patients registered on the waiting list in 2009 for one kidney transplant) before Italy which has low rate of living kidney transplant activity, Portugal, with a recent growth of transplant activity, but also the United States with high incidence of end stage renal disease and the United Kingdom which has a low rate of brain dead donors. For these last ones, France have one of the highest rates but it seems to reach a ceiling for 3 years. This report should lead a real strategy of the transplant from kidney living donor with a support for the healthcare professionals, the information of the general public, the patients and their family.

[Conceptions guiding the organization of organ procurement and transplantation in France, Canada and the United States]. / Les conceptions présidant à l'organisation du prélèvement d'organes et de la greffe en France, au Canada et aux États-Unis.

The goal of the seminar which took place in Paris on April 15th and 16th, 2010, was to understand the reasons which lead, on both side of the Atlantic and from a common basis of values, to different choice about essential rules concerning: consent strategies for after death organ donation: non heart beating donation; anonymity; living donation; paired-exchange donation ("crossed donation"); altruistic donation ("good Samaritan"); donation incentives; the place devoted to patient's representatives in health systems. The seminar also aimed at providing the French legislator, while the law on bioethics was being discussed, with international perspective and useful information regarding ethical practices and reflections on these issues.

[French citizens do not know much about their kidneys... results of a nationwide survey on renal diseases]. / Les Français connaissent mal leurs reins... Résultats d'une enquête sur les maladies rénales réalisée auprès du grand public.

Prevalence of chronic renal disease increases in France and in the world mainly because of ageing and diabetes mellitus. Early diagnosis and treatment of chronic renal disease allows significant slowing of the speed of degradation of glomerular filtration rate and may postpone or alleviate initiation of dialysis, an expensive and time consuming therapy. For the first time in France in October 2005, a campaign of information to improve awareness of French citizens on renal diseases was organised. A survey was conducted by BVA in a sample of the French population to evaluate their degree of knowledge on renal diseases. Our study showed that French citizens do not know much about anatomical and physiological considerations concerning their kidneys. They are not aware of symptoms revealing renal disease or therapy available in case of kidney failure. Almost one third of the persons interviewed are directly or indirectly touched by renal diseases. It seems that efforts should be made to better information of French citizens on renal diseases as a first step towards improvement of chronic renal failure treatment strategy.