title: [Organizational aspects of organ harvesting in France].
abstract: Organ transplantation of kidneys, liver, heart, lungs and pancreas is a routine practice in numerous French surgical centers with very good long-term results. Tissue transplantation of cornea, blood vessels, bone, and cardiac valves has also shown its efficacity and these tissues should be harvested whenever possible. Brain death is defined as the complete and irreversible destruction of the brain stem and cerebral cortex. The diagnosis of brain death is largely clinical but must be confirmed by EEG and cerebral arteriography. The Law of Caillavet has established the concept of "presumed consent" and has defined the judicial framework to permit organ harvesting. Nevertheless, there is still a high level of refusal of organ donation (in a third of cases) by the family of the decedent. At local and regional levels, control and coordination are provided by trained teams in liaison with the French Establishment for Transplantation (Etablissement français de greffes). The number of organ harvests grows steadily (18/million inhabitants in 2001) yet remains insufficient to meet the needs of the ever lengthening list of patients awaiting transplant. The profile of potential donors has also changed with time and poses increasing problems with regard to the quality of harvested organs.
authors.affiliation: Service d'Urologie, de transplantation rénale et pancréatique, Hôpital Pitié-Salpêtrière - Paris.
authors.forename: K
authors.initials: K
authors.lastname: Bensalah
authors.forename: M O
authors.initials: MO
authors.lastname: Bitker
authors.forename: B
authors.initials: B
authors.lastname: Barrou
mesh_terms: D001926:Brain Death; D005602:France; D006650:Histocompatibility Testing; D006801:Humans; D019724:Presumed Consent; D009927:Tissue and Organ Procurement / Q000331:legislation & jurisprudence / Q000458:organization & administration* / Q000706:statistics & numerical data