Why you’re more likely to get a kidney transplant in France

Every year, the US rejects thousands of kidneys from deceased older donors, the majority of which would have been used in France, according to a study published Monday that described the organs as a wasted resource that could save lives.

Why you're more likely to get a kidney transplant in France
French surgeons use kidneys from older donors than in the US. Photo: AFP

The analysis, published in JAMA Internal Medicine, found that French transplant centres would have transplanted more than 60 percent – about 17,500 kidneys – of the nearly 28,000 deceased-donor kidneys discarded in the United States between 2004 and 2014.

Five thousand Americans die each year while awaiting a kidney transplant, and there are about 90,000 currently on waiting lists.


The average age for the average donor was also striking: 39 in the US compared to 56 in France.

“They are almost 20 years older on average, it's huge,” Alexandre Loupy, the paper's lead author told AFP.

France addressed its own kidney shortage by steadily raising the age threshold for donors for older recipients. The UK also does not have an upper age limit for kidney donors, and successfully performed transplant surgery using a live kidney donor from an 80 year-old.

Even though there is a higher risk of failure from older donors, France found that patients receiving these organs lived longer and with a higher quality of life compared to those who remained on dialysis, said Loupy.

The US, by contrast, has remained more cautious: discarding about 18 percent of the nearly 160,000 deceased-donor kidneys over the time frame, about twice as high as the discard rate in France.

According to Loupy, budgetary constraints and performance indicators held US surgeons back from carrying out transplants deemed to be higher risk.

“They throw about 3,500 kidneys in the bin every year, which is about the same as the total number we transplant in France.”

“A 70-year-old patient does not need a graft that works for 30 years,” says Loupy, who hopes the study will lead the US to soften its policy.

In July, the administration of US President Donald Trump signed an executive order to improve kidney care and double the number of transplants by 2030.

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France brings in free contraception for all women aged 18-25

Free birth control for all women under 25 will be available in France from Saturday, expanding a scheme targeting under-18s to ensure young women don't stop taking contraception because they cannot afford it.

France brings in free contraception for all women aged 18-25
A doctor holds an interuterine contraceptive device (IUD) before inserting it in a patient. Photo: Adek Berry/AFP

The scheme, which could benefit three million women, covers the pill, IUDs, contraceptive patches and other methods composed of steroid hormones. Contraception for minors was already free in France.

Several European countries, including Belgium, Germany, the Netherlands and Norway, make contraception free for teens. Britain makes several forms of contraception free to all.

France announced the extension to women under 25 in September, saying surveys showed a decline in the use of contraception mainly for financial reasons.

The move is part of a series of measures taken by President Emmanuel Macron’s government to boost women’s rights and alleviate youth poverty. The free provision is supported by women’s groups including the association En Avant Tous.

“Between 18 and 25-years-old, women are very vulnerable because they lose a lot of rights compared to when they were minors and are very precarious economically,” spokeswoman Louise Delavier told AFP.

Leslie Fonquerne, an expert in gender issues, said there was more to be done.

“This measure in no way resolves the imbalance in the contraceptive burden between women and men,” the sociologist said.

In some developed countries, the free contraception won by women after decades of campaigning is coming under attack again from the religious right.

In the United States, former president Barack Obama’s signature health reform, known as Obamacare, gave most people with health insurance free access to birth control.

But his successor Donald Trump scrapped the measure, allowing employers to opt out of providing contraception coverage on religious grounds — a decision upheld by the Supreme Court in 2020.

Poland’s conservative government has also heavily restricted access to emergency contraception as part of its war on birth control.