Faced with the growing need for organs for transplants, France must strengthen its organization but also explore new avenues, according to the Ethics Committee, which is opening the door to research on the transplantation of organs from pigs.
Currently, "« Patients are exposed to increasing losses of opportunity, while all the levers that could better meet their needs are not being fully utilized.«", notes the CCNE, which published on Tuesday, September 15 an opinion on the ethical issues surrounding organ donation.
In less than a decade, the number of patients on the waiting list has increased by 50%, to approach 24,000 at the beginning of 2026. In 2025, France achieved a record 6,148 organ transplants, but at the same time 966 patients died for lack of a transplant.
However, there is no "inevitability," considers the body chaired by Jean-François Delfraissy: the example of Spain shows that significant progress is possible.
Seven proposals to rethink the process, from prevention to transplantation
From prevention to access to transplantation, the report co-led by Professor Jacques Duranteau and the president of the Renaloo association, Yvanie Caillé, formulates seven proposals to partially reshape the French system.
In hospitals, a key link, the CCNE calls for the removal of several organizational obstacles: strengthening coordination teams, developing territorial networks, expanding organ donation after controlled circulatory arrest, systematizing the registration of potential donors…
To expand the possibilities for kidney transplants, he recommends developing living donation to a relative, which is less common than in other countries.
Another recommendation: to authorize non-directed kidney donation, which has been prohibited until now, while respecting anonymity and within a strict legal and medical framework.
This practice, which involves donating a kidney while alive without knowing the recipient, has enabled more than 1,000 transplants in the United Kingdom since its implementation in the mid-2000s.
As the rate of opposition from relatives of potential deceased donors continues to increase, the CCNE calls for strengthening information and education, particularly among young people.
Jean-François Delfraissy, president of the National Consultative Ethics Committee (CCNE), at the National Assembly in Paris, July 15, 2026. (Credit: AFP – Stephane De Sakutin)
The CCNE paves the way for xenografts in France, under a strict framework
The most unprecedented position: the Ethics Committee is paving the way for research in France on xenografts within a "demanding" ethical, scientific and health framework, following a call in 2025 from the Academy of Medicine for a national plan on xenotransplantations.
It recommends anticipating the ethical, regulatory and health issues related to research on organ transplantation from genetically modified pigs, before any possible clinical generalization.
The benefits, consent and patient selection, but also the risks associated with the possible transmission of pathogens or the living conditions of animals are among the many questions.
“ Xenotransplantation should not replace human organ donation«", the Ethics Committee points out, but, if its effectiveness and safety were demonstrated, it could be considered as "« complementary solution »"for patients who cannot receive a human graft or are awaiting transplantation.
Read also First: a xenograft serves as a bridge while awaiting a human graft
Pigs: a new hope for xenotransplantation
For some patients with kidney failure, a xenograft could be an alternative to dialysis while awaiting a human transplant, the opinion notes.
Renaloo« now awaits the concrete translation of the CCNE's recommendations into public policies, the next organ transplant plan, and future bioethical debates.«", the association emphasized in a statement.
Faced with organ shortages, the transplantation of animal organs into humans is fueling increasing research worldwide, focused on the transplantation of pig organs (kidney, liver), genetically modified to avoid acute rejection and reduce infectious risks.
Read also Pig organ transplantation in humans: the scientific challenges of xenotransplantation
Monkeys were initially considered the best potential donors, given their close genetic relationship to humans. However, there are not large stocks of monkeys in captivity, some species are endangered, and they pose a risk of disease transmission.
Pigs have therefore become better potential donors due to the many similarities between their organs and those of humans. And xenotransplantation, long considered the stuff of science fiction, has benefited from advances in gene editing and the control of the immune system's response.
In the United States, where several experimental transplants have been carried out since 2021, health authorities have given their approval in 2025 for the launch of clinical trials on pig kidney transplants to humans.
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