This thesis aims at examining the development of kidney explantations for transplantation purposes in the region of Thuringia by 1990 considering particular circumstances within the development of transplantation medicine in the GDR compared to federal and international ones. All together 333 donor records of the former Department of Coordination for Kidney Transplantation in the GDR, Berlin-Friedrichshain, being available for the various investigations, were analysed. The details referring to the years of 1974/1975 were taken from records of the Department of Nephrology of the former Medical Academy of Erfurt. Additional information were provided by statistics of the German Foundation of Organ Transplantation, the European Dialysis and Transplant Association (EDTA), Eurotransplant International Foundation as well as a number of interviews. In the GDR 6,264 donor kidneys had been taken, 687 of them originated in Thuringia. 61% of these organs were transplanted, but on the federal level the rate of transplantations reached about 90% and more. 40% of the rejected organs failed due to bad perfusion and "pyelonephritic"/arteriosclerotic changes, 18 % because of anatomical variations, 11% as a result of "inadequate explantation" and 8% owing to primary trauma. In addition, there was a renal impairment due to long and cold times of ischemia (12%), particularly on account of long transports. Very critical evaluation of the donors and the explanted organs led to heavy selection. The average Thuringian kidney donors‘ age was about 29, 72% of them being male patients. According to the share of age, sex and accidents resulting in deaths 68% of the cases had craniocerebral traumas. 78% of the transplanted kidneys were grafted in the GDR, 16% supported by Intertransplant and 6% were mediated by Eurotransplant. In Thuringia 70% of the organ explantions were carried out at universities and priority hospitals, from these 58% of all the kidney explantations were realised by the team working at the Medical Academy of Erfurt from 1974 to 1990. All in all, in the GDR 20 kidneys per one million inhabitants were taken a year, but only 14 of the identical category were transplanted. In the Federal Republic of Germany an average of 20 kidneys per million inhabitants were provided. Comparable data have not been found in the Eastern European countries, the highest number of explantations was reached in former Czechoslovakia with 9-11 kidneys per one million inhabitants. |