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Martin Börgel, Managing Director of the DGFG, talks about the development and history of DGFG and about what moves the NPO in the future.
This year, the German Society for Tissue Transplantation (DGFG) celebrates its 15th anniversary. At the same time, DGFG can look back on 25 years of tissue donation in Germany. Last year, we succeeded in realizing almost 3,000 tissue donations. 2,811 people donated their cornea, and we were able to provide 4,165 patients with a corneal transplant to save them from corneal blindness.
Besides the consistently positive development of tissue donation in Germany, we still have to overcome a lack of tissues, such as corneas, and especially heart valves and vessels. One factor leading to this circumstance is the general lack of knowledge in the population about the possibility of donating tissue – in the case of cornea even up to 72 hours after death.
While many people are familiar with organ donation and its organization, in Germany, tissue donation is mostly completely unknown. Therefore, we spend a lot of afford in promoting tissue donation and raising awareness towards this special field. One of our highlights was the photography exhibition “Experience Tissue Donation”, which was on display as an open-air installation on Hannah-Arendt-Platz in Hanover from May 30 to June 13, 2022. The photographs and stories of this exhibition were intended to make tissue donation accessible to the general public and easy to grasp and understand. In the context of this open air exhibition, we also organized a public, informative event where transplant recipients, DGFG staff as well as transplant physicians showed the different facets of tissue donation and our work.
Milestones in 25 years of tissue donation in Germany
With the foundation of the DSO-G (Gemeinnützige Gesellschaft für Gewebetransplantation) in 1997, as a subsidiary of DSO (Deutsche Stiftung Organtransplantation), the aim was to operate in tissue donation separately from organ donation. This separation was initiated to focus on constructing the DSO and sharpening its profile as a coordinating body for organ donations. A few years later, in 2000, the DSO was finally mandated as the central coordinating organization for organ donation.
After commissioning the DSO as the coordinating body for organ donation and Eurotransplant as the allocation body for organs, I became managing director of the DSO-G in 2002. Together we started to restructure the DSO-G. We gradually detached tissue donation from organ donation and focused in particular on corneal donation from cardiovascular deceased, performed by organ donation coordinators. Heart valves and vessels, however, continued to be obtained exclusively from organ doners.
Another milestone was the EU Directive on the donation, processing and distribution of human tissues and cells: This directive (2004/23/EC) was transferred into German law in 2007 with the national Tissue Act. This framework united all sub-areas of tissue donation, including, for example, consent and data transfer, on one legal level. The DSO-G was highly involved in the implementation of this directive. As a result, the donation program became independent of the DSO and organ donation. Tissue banks were also established under these new conditions, standards, and officially monitored quality guidelines – the basis of our daily work
Probably the biggest milestone was the coming into force of the Tissue Act in 2007: the spatial and legal separation from the DSO and the foundation of the DGFG, supported by the Hanover Medical School, and the University Hospitals of Dresden and Leipzig as its shareholders.
In 2015, the University Medical Center Rostock and in 2017 the largest diaconal hospital in Mecklenburg-Vorpommern, the Dietrich-Bonhoeffer-Clinic Neubrandenburg, joined the DGFG as additional shareholders.
In addition to expanding tissue donation, DGFG was able to work with partners to allocate new tissue preparations to improve patient care with highly specialized transplants: including
Since 2007, the development of the DGFG is steadily upward. The focus on HKTS donations has led to a strong improvement in transplant supply in Germany. In recent years, DGFG has established a nationwide tissue network consisting of numerous clinics and 13 tissue banks. The network supplies more than 120 transplant programs in Germany with corneas, 35 clinics with heart valves and blood vessels, and about 40 facilities with amniotic preparations (the inner egg skin of the placenta).
With about 50 of its own coordinators at 30 locations throughout Germany to be on site at the clinics and implement and realize tissue donation, the DGFG has succeeded in building a donation program that has withstood major challenges such as the Corona pandemic. In 2021, more than 6,600 patients received a tissue transplant from a tissue bank in the DGFG network. Since 2007, this number has increased to almost 60,000 patients.
Today, DGFG is involved in many international projects to help people, for example from Rwanda, India or Romania, with tissue donations such as corneas and heart valves. These projects often have different histories of origin.
In India, the focus is on the transfer of knowledge in both directions, which has resulted in a joint project, funded by the “Gesellschaft für Internationale Zusammenarbeit” (GIZ). Two new collection centers in the northern region of Delhi were already implemented successfully. Next step: the development of a data management system to improve the processes and their efficiency.
The commitment in Sub-Sahara Africa, on the other hand, comes from private initiatives: From time to time, corneal surgeons from the DGFG network perform corneal transplantations during their vacations with great private commitment. If possible, the DGFG supports them with transplants. According to the same principle, other private persons or associations, such as “Cornea Help”, approach the DGFG. To elevate this assistance to a higher, more sustainable level, we now have set ourselves the goal of systematizing this approach and focusing on more sustainability and help for self-help. The aim: to share our knowledge and experience in setting up donation programs and tissue banks by organizations worldwide, to bring together experts from Africa on the ground, to bundle synergies and to raise awareness of society, politics and other multipliers on the topic of tissue donation.
One example is an exchange meeting at this year’s conference of the South African Tissue Banking Association (SATiBA for short) on November 13, 2022 – organized by the World Union of Tissue Banking Associations (WUTBA) together with the Global Alliance of Eye Bank Associations (GAEBA) and the German Society for Tissue Transplantation (DGFG).
