title: [Outcome and outlook of living donor kidney transplantation activity in France].
abstract: BACKGROUND
  In France, the bioethic law of 2004 authorized the extension of the living donor (LD) pool to members of the extended family and any person justifying of a 2 year-long relationship. The number of living donor kidney transplantation (LDKT) increased until reaching a maximum of 246 grafts in 2006 (9% of total activity). Two years later, in 2008, LKG activity slowed down to 7.6% of the total activity (222 grafts).
  
  
  METHODS
  We analyzed all LDKT carried out in France since 2000 according to various indicators. In addition, a questionnaire was sent to renal transplant teams in order to identify potential causes for the decrease in LKG observed in France.
  
  
  RESULTS
  From 2000 to 2006, over 1400 LDKT were performed in France. However, donor to recipient relations show that the large increase observed in 2006 was not linked to the extension of the LD pool. LDKT activity then started decreasing as soon as 2007. The questionnaire was sent back by 40/44 (91%) renal transplant teams. Their answers led to the identification of potential constrain impacting LDKT activity in France. Among these obstacles: workload and time-consuming to prepare the transplantation and the donor, ethical constrains and lack of appropriate communication and information delivered to the professionals.
  
  
  CONCLUSIONS
  The important increase in LKG activity in 2006 is not clearly understood. However, several approaches to develop the activity in the next years have been identified.
authors.affiliation: Agence de la biomédecine, direction médicale et scientifique-1, avenue du Stade-de-France-Saint-Denis, 93212 La-Plaine cedex, France. francoisxavier.lamy@biomedecine.fr
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Lamy
authors.forename: Emilie
authors.initials: E
authors.lastname: Savoye
authors.forename: Marie-Alice
authors.initials: MA
authors.lastname: Macher
authors.forename: Marie
authors.initials: M
authors.lastname: Thuong
mesh_terms: D003142:Communication; D004989:Ethics; D005190:Family; D005602:France / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data* / Q000639:trends*; D019520:Living Donors / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016526:Workload