[Organ transplantation and insurability]

Major organ transplant today is to be regarded as an established therapeutic procedure for treating irreversible organ failure. The creation of the necessary technological, immunological and ethical foundations in the 20th century brought about a true breakthrough in transplantation medicine. The presentation outlines various clinical pictures that can lead to chronic organ failure based on examples of heart, liver and kidney diseases. The long-term survival rates of patients/transplants are outlined and a comparison of international statistics drawn. Different problems that can arise in connection with a transplant, e.g. rejection reactions or transplant arteriosclerosis, are also broached. The heterogeneous risk profiles of the immunosuppressant drugs that the transplant recipient must take for the rest of his life are also discussed at length. There is no doubt about the fact that major organ transplants constitute a challenge to insurance medicine. The extreme extramortality of transplant recipients in the initial postoperative phase, makes immediate acceptance of transplant recipient applicants for life insurance prohibitive. It is, however, possible today to accept liver or kidney transplant recipients who have experienced a favourable post-transplant course, with adequate postponement. Finally, the presentation touches upon the different focuses of science's attempts to counteract a growing shortage of organs.