Transplantation and donation: analysis of new initiatives. Criteria for brain death in organ donors. Who can be an organ donor: living and dead donors

Healthy, prosperous people rarely think about the fact that there are those for whom tomorrow may not come. It's about about patients with severe forms of heart failure who require a donor heart transplant.

Waiting for a suitable heart can take years, and when one is found, surgery may not be possible due to the patient's condition. At the same time, anyone can express a desire after death to donate their heart to those to whom it can save a life. How to become a heart donor? You will find the answer in the article.

Of course, a person can become a heart donor only after death. You can become a donor only if you meet certain criteria:

absence of diseases of cardio-vascular system;
age less than 60 years;
absence of hepatitis B and C, as well as HIV infection. AT rare cases people infected with hepatitis are allowed to donate;
death . That is, you can become a donor only if you receive injuries that caused brain death. Sometimes brain activity completely stops after an extensive cerebral hemorrhage.

Usually, donors are people who have experienced serious accidents or received severe industrial injuries. Most of these patients end up in hospitals where urgent care. It is to such institutions that requests are sent to clinics where heart transplant operations are performed.

Legislation: who must consent to a transplant

In our country, there is a law of posthumous donation

In Europe and America, a person becomes a potential organ donor while still alive. To do this, you need to sign the relevant documents, which prescribe permission to use organs for transplantation in the event of a person's death. If such a document is signed, then doctors have the right not to ask permission from a relative of the deceased patient to harvest organs.

In our country, there is a so-called presumption of consent to the removal of organs. This means that if a person did not sign a refusal from posthumous donation during his lifetime, the organs necessary to save the life of another patient can be removed from him.

However, there is one “but”: close relatives or guardians of the patient have the right to refuse to harvest organs. Unfortunately, in our country, relatives of patients often refuse to harvest organs, fearing unlawful actions on the part of doctors.

Is it possible to deceive the relatives of patients

There are many nuances in heart transplantation that must be taken into account, one of them is the psychological burden of relatives

The reasons for the refusal of organ harvesting by the patient's relatives are clear from psychological point vision. Indeed, when native person is still alive, that is, he continues to beat, it is difficult to imagine that he will be confiscated internal organs.

However, removal is possible only after brain death has been ascertained. Brain death means that a person is no more: a vegetative existence awaits him, supported by life support systems.

Brain death is ascertained by a council of doctors, and in this case it is impossible to deceive the patient's relatives. If doctors offer the removal of organs for transplantation, it is worth thinking about the fact that a person after death can save a life, that is, perform a noble deed.

Who Cannot Have Organs Donated?

The heart and other organs cannot be removed for transplantation in the following cases:

the patient suffered from diseases of the cardiovascular system, was infected with AIDS or hepatitis
the deceased was a minor orphan or was brought up in a dysfunctional family. This measure is necessary in order to prevent the illegal removal of organs.
The identity of the deceased could not be established. When removing organs from such a patient, doctors face criminal liability.

How to become a heart donor

During life, the relatives of a person who decided to donate must know about his intention

Due to the peculiarities of Russian legislation, it is not required to take any action in order to become a heart donor. You just need to carefully monitor your health and try to lead in order to avoid the development of diseases of the cardiovascular system.

It is also important that close relatives of a potential donor know about his intention. Otherwise, they may refuse to remove the heart and other organs needed for transplantation. Naturally, for prompt identification, you must always have a passport or other documents with you.

The first time such a large-scale surgical intervention was carried out in 1987 English doctors: it was then for the first time in history that a patient became a heart donor whose life was saved.

In order to become a heart donor in our country, you do not need to make any special efforts. It is important to express your desire to close relatives, as well as try to maintain your health for a long time. The intention to give your heart in the truest sense of the word indicates that a person has achieved high level self-awareness and is ready for noble deeds even after his own death.

From this video you can learn about the device that saves donor heart before surgery:

Donation is the provision by donors of their organs and tissues for transplantation to another person, and blood for transfusion.

It is the donation of blood and its components that is most common throughout the world, and there are usually no problems with it, because blood can be donated for a long period of life. Is it safe to donate blood? - No, it is completely safe if the amount of blood taken is not critical for the further functioning of the body.

With organ donation, the situation is more complicated, because some organs can only be obtained for transplantation after the death of a person.

In Russia, there is a law that defines the conditions and procedure for transplantation of human organs and (or) tissues, based on modern achievements science and medical practice and taking into account the recommendations of the World Health Organization. Transplantation or transplantation of human organs and tissues is a means of saving lives and restoring human health and must be carried out on the basis of compliance with the law Russian Federation and human rights in accordance with the humanitarian principles proclaimed by the international community, while the interests of the individual should take precedence over the interests of society and science.

How to become an organ donor during your lifetime?

The legislation of our country provides for the lifetime donation of paired organs, for example, kidneys and parts of organs or tissues, the loss of which does not pose a danger to life and health, for example, part of the liver, part small intestine, lung lobe, part of the pancreas, bone marrow. Many people ask: what are the consequences of a transplant bone marrow for a donor? – Bone marrow from a donor for transplantation is usually taken from femur. It's not at all dangerous because a large number of the bone marrow remains in the flat bones of the donor, and he will not experience deficiencies in blood components.

You can also become a liver donor: one or two lobes of the liver are transplanted from a living person, which grow to normal sizes in the body of the recipient, exactly the same happens full recovery donor liver.

The process of lifetime organ and tissue donation technically includes the following steps:

- donor passes medical examination for the absence of contraindications to donation;
- if the donation is carried out in favor of a specific person, then the biological compatibility of the donor and the recipient is checked;
- the donor (as well as the recipient, if he already exists) is being prepared for a surgical intervention for organ transplantation; are being studied possible consequences transplantation for the donor and recipient; are issued Required documents and final consent for transplantation is obtained;
- Transplant surgery is performed.

Lifetime donation in our country is carried out free of charge and only in relation to relatives, the sale and similar means of distribution of organs are prohibited. But some organs can only be harvested for transplantation posthumously.

How to become an organ donor posthumously?

Donation is very noble, and the benefits of donation are undeniable. Postmortem organ donation is especially important, when viable organs and tissues are already dead person able to save the still living seriously ill. In our country, there is a presumption of consent to posthumous donation. This means that after death, each person becomes a potential donor, if during his lifetime he did not have time to issue a written refusal to donate organs. The same refusal can be issued by close relatives or legal representative person, if his will cannot be carried out. The most correct is donation from young and healthy people whose death was untimely. This is a great opportunity to continue life after death, giving hope for recovery to fading patients waiting for donor organs. Posthumous donation is especially important, because only after death can one become a donor of the heart, eye tissue, and lungs.

Fear of misconduct medical workers not worth it, because the removal of organs is carried out only after the death is declared and only with the permission of the head physician of the hospital. If a person wants to become an organ donor posthumously, then he does not need to take any action, just take care of his health, observe healthy lifestyle life. And then, even after death, he will be able to perform a noble deed. For the removal of organs from a deceased child, the obligatory consent of his parents is required - in this case, the presumption of disagreement is applied. Under no circumstances can the organs of deceased orphans and children from dysfunctional families be used. It is forbidden to consider as potential donors and deceased people whose identity has not been established. The removal of their organs is criminalized.

How much does a donation cost?

The Internet is replete with ads: "I will sell a kidney", "I will become a kidney donor." However, it is worth knowing that officially selling your internal organs, including the kidneys, will not work. It will not be possible to do this not only in Russia, but also in all developed countries, with the exception of Iran. There, the sale is allowed at the state level with total control by representatives of medical departments.

In addition, since 2013, a law came into force that abolished monetary rewards for donating blood to donors. Competent experts stressed that free blood donation is a globally accepted practice.

Historically, the donation system began in the United States. And in this country, where the system of requested consent has been in place for more than 40 years, about 65% of citizens are voluntary organ donors. This fact is reflected in the national register, as well as in the personal documents of citizens. According to Russian sociologists, no more than 5% of Russians agree to donate after death. Even fewer citizens are willing to give permission for the removal of organs from their loved ones.

As the head of the department of neuro- and pathopsychology of Moscow State University named after M.V. Lomonosov, President of the Moscow Psychoanalytic Society Alexander Tkhostov, he is a voluntary donor in the United States, but "it is not a fact that he would have made the same document in Russia." Purely by psychological reasons. “Voluntary donation is not developing in Russia, not because we have an illiterate population,” the expert believes. - In Russia, there is a global mistrust between the population and all branches of government. And it has a direct bearing on medicine. We constantly fear that we will be deceived. And the only way to find consensus, at least on some individual issues, is to be as open as possible.”

Last week the Constitutional Court of the Russian Federation in again that the presumption of consent to posthumous donation, that is, the presumed readiness of every adult Russian to become a potential organ donor, does not violate the rights of citizens.

If a person during his lifetime did not declare that he did not want his organs to be used for transplantation, and after death his relatives did not do this, it is considered that the deceased agreed to become a donor. At the same time, in Russia there is still no single register where information about the consent or disagreement of patients to become donors would be stored. You can declare your will orally in the presence of witnesses or in writing (then you need to certify the document with a notary or the head of the hospital). But it is unclear whether such a system is effective. In addition, doctors complain that almost no one understands what brain death is, and the opinion that organs are taken from patients who are still alive is not uncommon.

Wouldn't it be better to introduce in Russia the practice of requested consent, so that only the one who declared his desire could become a donor? Why is it unethical to refuse organ transplantation to those who themselves do not want to be a potential donor? What is brain death and how is it diagnosed?

Mikhail Kaabak

doctor medical sciences, Head of the Department of Kidney Transplantation of the Russian scientific center surgery them. Academician B.V. Petrovsky RAMS

- The presumption of consent - it sounds scary. Does this mean that the body after death no longer belongs to a person?

The presumption of consent is a normal practice in many countries, last year in the UK. At the same time, the presumption of consent and informed consent identical in their humanity. From an ethical point of view, it is important that an adult make the decision to donate.

- Can relatives intervene?

In Russia, tell relatives about their disagreement with the removal of organs of the deceased loved one. The law of doctors ask relatives about it, but it does not prohibit it either, so what the doctor will do is a matter of personal ethics.

- Are there cases of abuse of the presumption of consent?

The Constitutional Court called for improving the current legislation back in 2003 after. Then the doctors regional hospital unable to tell the mother about the death of her son, she sat at his bedside, and in order to remove the organs, they took the body under the pretext of conducting research. The Constitutional Court confirmed that the presumption of consent does not violate the rights of citizens, but the practice of application needs to be clarified. This has not happened yet.

What are they doing to prevent this from happening again?

A few years ago, the Ministry of Health drafted a bill “On the donation of organs, parts of human organs and their transplantation (transplant)”. If it is finally accepted, doctors will be required to try to contact relatives to inform them of the death of a loved one. But I'm afraid that doctors who want to avoid talking to relatives will easily bypass this point. For example, a mother sits at the bedside of a sick person, and she receives a call on her home phone. And in the event of litigation, an unscrupulous doctor will say that it is not written on the back of the woman who is sitting by the bed that she is a mother. These things can happen, you know?

The most important thing that is in the latest version of the bill is the creation of a procedure that will allow fixing the will of a person during his lifetime, how to deal with his organs after death. There were rumors that it was planned to create databases of people who refused to donate, and someone even suggested that such patients be denied transplantation. This, of course, is stupidity and a violation of human rights, it must be ensured that nothing of the kind appears in the new law. The will for posthumous donation must be free from any pressure, otherwise such practice cannot be considered ethical.

- Is the number of transplants similar or different in Russia and abroad?

About 1,000 kidney transplants are performed annually in Russia. And this is comparable to the data Western countries in terms of proportions: the number of transplants waiting and the number of transplants being performed.

Mikhail Sinkin

neurologist - clinical neurophysiologist, senior researcher at N.V. Sklifosovsky Research Institute for Emergency Medicine

- We know from the series that after clinical death a person's life is supported in intensive care while relatives decide on their consent to organ donation. Is it humane? After all, if a person breathes, he is alive.

- Brain death is completely equivalent to human death. This has been proven over 50 years ago and is now accepted worldwide. The modern level of medicine allows transplanting or mechanically replacing almost any organ - the heart, lungs, liver or kidneys. If the brain has collapsed and died, it cannot be replaced in any way. This means that the person as a person is irretrievably lost. The difference between ordinary biological death and brain death is only the presence of a heartbeat. Other Clinical signs coincide: there are no breathing, stem reflexes and muscle tone pupils are dilated. Brain death can occur only in intensive care, when it is possible to artificially maintain the functions of the heart and lungs. If not carried out intensive care, then with the death of the brain, the heart will also stop.

There is no direct connection between the statement of brain death and organ transplantation. A person dies regardless of whether he will be a donor or not. To diagnose brain death, a council gathers, it necessarily includes a resuscitator and a neurologist, at least two doctors. From January 1, an updated statement of brain death is in effect. The requirements for the diagnostic process are among the most stringent in the world. Need to know the medical history computed tomography, content analysis toxic substances, drugs that can depress consciousness. After that, observe the patient for at least six hours. All this is recorded in a special protocol, which is signed by several doctors. In difficult cases, EEG and angiography are performed to confirm brain death to determine cessation. electrical activity brain and cerebral blood flow (it has been established that if blood does not flow for more than half an hour, the brain dies). More often than in 50% of cases with brain death, the so-called spinal automatism is observed - movements of the arms or legs. These reflexes close at the level spinal cord, its activity increases when the brain ceases to function and exert an inhibitory effect. In such cases, additional checks are carried out.

Lack of spontaneous breathing is one of the main signs of brain death. In intensive care, many patients in serious condition the so-called artificial lung ventilation (ALV) is carried out, when the apparatus breathes for a person. Therefore, during the diagnosis of brain death in the presence of members of the council, the patient is disconnected from the apparatus for some time. artificial ventilation and look to see if the breath appears. Everything is carried out according to a special procedure that is safe for the patient, and if there is no breathing for a certain time, it means that respiratory center died and will never recover.

Nephrologists consider the kidneys to be a unique human organ. They work without stopping even for a minute.

Their work is difficult and replaces the whole system. Without them, our existence is impossible, because they purify our blood from harmful substances.

If their work fails, the toxins cease to be excreted from the body, it becomes poisoned. Output is regular. In difficult cases, a transplant is required.

general information

They are located in the retroperitoneal space, have the shape of a bean. The mass of one is 120−200 g.

There are many functions. The main - excretory - remove water and water-soluble substances from the body. There are others: hematopoietic, protective, endocrine.

They are patient and do not complain about their health, more often they get sick silently. But for some signs, you can suspect problems with them:

swelling of the eyelids, hands, ankles due to fluid retention;
pain in lumbar region, which is caused by a stretched capsule around them;
- sign;
high blood pressure for no reason - the kidneys or vessels that feed them with blood are sick;
or reddish - there is blood, they suspect.
urination is difficult (, burning, pain, rare /).

The list of kidney diseases is extensive: kidney failure, etc.

With these diseases, if left untreated, a person can die. Patients undergo hemodialysis to purify the blood. But it doesn't always help. Then transplantation is indicated. It - paired organ, so the functions of one can be performed by another.

Thanks to this feature, people were allowed to become donors of this organ. Thousands of Russians need. They have been waiting for a transplant for years. But only 500 people undergo surgery every year - the rest die.

Potential Donors

The Law of the Russian Federation "On Transplantation of Human Organs and (or) Tissues" defines the circle of those who can become a donor. It:

living relatives;
people who are not related to the patient;
the dead are the corpses of people whose brain is dead and whose heart is contracting.

Relatives

You can be on a “waiting list” for transplantation for decades. To save the patient, his relatives decide to give him their kidney.

First, the closest relatives (brother, sister, father, mother) are considered for this role. An identical twin would be ideal. The risk of rejection of a foreign organ will be minimal.

Then - indirect relatives (relatives of the husband or wife, friends, relatives, acquaintances).

The main thing is that the organs of relatives are healthy, and only doctors will determine this.

Other candidates

But more often, a person who is ready to part with a kidney (for money, of course) becomes a stranger who meets all the criteria.

You can also take it from the dead, if death (biological or brain) is recorded. The law determines when the dead can donate an organ.

There are 2 types of non-living donors:

With biological death, when there is a written lifetime consent of the deceased to become a donor.
After brain death, recorded by doctors. The cause of death is often incompatible with life injuries after accidents.

How to get advice

It is necessary to undergo a deep medical examination to check your health and determine compliance with the tissues of the recipient.

The organ must not be taken until received final results analyzes and tests performed. Are determined possible risks during the operation.

It is often found that a person who decides to donate an organ cannot donate his kidney because of the detected malfunctions in the body.

Transplant conditions and how to donate a kidney?

By the way, only kidneys are harvested from a living person. Heart, liver, lungs are taken only from corpses.

The main conditions for transplantation, age - from 18 to 50 years. Diseases - upon detection infectious diseases, HIV, hepatitis, tumors, ischemia physicians will not be allowed to become a donor. With hypertension and atherosclerosis, organ retrieval is possible.

A person who wants to donate his organ goes through a series of stages:

He is carefully examined for contraindications to donation. Doctors are responsible for the result of the operation, so you need to know if he is healthy for her. If there are no complaints from doctors, they proceed to the next stage.
If the recipient is already known, it is checked whether the organ is suitable for him. Blood groups are determined. For transplant participants, they must match. Check if biological tissues are compatible.
The donor is admitted to the clinic. It is examined by specialists and carried out secondary analyzes: Ultrasound ECHO cardiography of the heart, X-ray of the lungs, blood tests.
A transplant is being prepared: they study possible risks, draw up documents and receive consent for the operation.
A transplant is underway.

Cost and how the deal goes

Living donation in Russia is allowed only free of charge and only in relation to relatives. Nothing will change in this regard in the coming years.

This law applies to all developing countries. The sale of organs is prohibited by the states of all countries and is allowed only in Iran.

How much does a kidney transplant cost in Russia? The final cost is determined by the price of the organ and operation.

This operation is complex and therefore expensive. On average, it costs $20,000. The price ranges from $10,000 to $100,000.

The cost is determined by the prestige of the clinic, the fame of the surgeon. The luminaries operate in an elite clinic, which means that it will cost 30-100 thousand dollars. The urgency of the operation also affects the price.

In the regions, they can also do a free transplant. But not everything is so smooth here. The state allocates 1.2 million rubles every year. on them. And for how many patients will this money be enough? There are many patients, a huge queue forms, and it moves very slowly.

In the Russian Federation, organs are transplanted in clinics. Their list is on the Internet. The most famous are the oncological and hematological centers at the Russian Academy of Medical Sciences, Moscow MA named after. Sechenov, University. Pavlov in St. Petersburg.

Black market price

But the need for donor organs is great, and they are sorely lacking. appears. There are many ads on the Internet about the desire of people to sell a piece of themselves.

But a natural question arises: what would be the price of a kidney organ if the sale of the organ were officially allowed? Today, a kidney would cost from 1.5 million rubles. up to 15 million

This figure was obtained by converting its value on the black market abroad into rubles.

A lot of money, and there are people who are ready to say goodbye to the kidney organ. There are many who seek to get rich in this way.

The price is set by the donor. In large metropolitan areas, a kidney is sold for high price, and the highest - in Moscow, where they will ask for it from $ 10,000.

In small towns with small salaries and low prices organs are cheaper. And the cheapest ones are in provincial villages. There you can buy it for only 30 thousand rubles.

The order of the nephrectomy

It took a week from hospitalization to surgery. After 7 days, a nephrectomy (kidney sampling) is performed. Here's how the operation goes.

First, the anesthetist gives the donor general anesthesia. After the catheter is connected (cleans bladder) and drainage, (provides hydrobalance). Then they carry out: make 2-4 small incisions of 1 cm each on the side of the abdomen. Access to the kidney is open.

The surgeon carefully separates the kidney, adrenal gland, and ureter from the tissues and removes the organ. This is the most critical stage of the operation. The main thing in it is not to damage anything and prevent large blood loss. Blood vessels, the ureters are excised, then clamped. Wounds are sutured and a sterile bandage is applied.

Quite rarely, in this case, abdominal surgery. Surgical intervention lasts 2-3 hours and is recorded on camera. After the operation, the donor spends the first day in intensive care, where he regains consciousness under the supervision of doctors.

Most often, surgeons take left kidney- there are closer vessels and a longer vein.

Possible risks of nephrectomy and recovery period after surgery

She is not dangerous. The probability of dying on the operating table is small, 1:3,000, although it is impossible to foresee everything.

If he feels satisfactory the next day, he is transferred to the ward. There will be no pain, analgesics will cope with it. If necessary, a short course of antibiotics will be prescribed. He is in the hospital depending on his condition.

Possible complications are rare, but still there are infections, bleeding and blood clots, damage to nearby organs.

The final recovery lasts up to a year, at this time you need to carefully monitor yourself and follow all the doctor's recommendations.

Consequences and conclusion

A healthy person recovers within a month and a half and goes to work. active life he can lead in a year. Women are not allowed to give birth afterwards.

Donor life is like life ordinary people: habitual way of life, daily activities. Life expectancy, according to most transplantologists, is not reduced. The risk of diseases of the remaining kidney is small and occurs in 0.5% of donors.

But each organism is individual, it is not worth excluding complications in the future, even if they are small, even with a normally proceeding rehabilitation. Yes, and about the problemsthat may arise, you need to know:

The human body does not have extra organs, but it can share some parts if necessary. Kidney removal is a risk for the donor, but a salvation for the patient.

Before deciding to take this serious step, you need to think carefully, choose a reliable clinic and unconditionally listen to the doctor. Donation is a “quiet feat” for another person.

About 1,500 organ transplants are performed in Russia every year. This is many times less than in the US, UK, Brazil and many other countries. The development of transplantation treatment is hampered not only by outdated legislative acts, but also by the poor awareness of citizens in this area.

We will acquaint readers with the data that seem to be the most important for understanding the peculiarities of transplantation in Russia.

Source: depositphotos.com

Presumption of consent

The legislation of the Russian Federation regarding donation is based on the presumption of consent. This means that any deceased capable citizen is a candidate for donors. At the same time, every Russian has the right to report his desire or unwillingness to donate his organs and tissues for the benefit of people after death. This statement may be oral (made in the presence of two witnesses) or written. In the latter case, it must be certified by a notary or the head physician of the hospital.

It should be noted that Russians very rarely announce their will regarding posthumous donation. In addition, the country has not yet created a federal register of such applications, so this system can hardly be called effective.

Rights of the deceased donor's relatives

This is one of the most problematic aspects of post-mortem donation. According to the current legislation, the relatives of the deceased, in the absence of his lifetime consent, have the right to oppose the removal of organs for the purpose of transplantation. However, the law does not regulate the actions of a doctor in such a situation. The doctor must inform people about the death or dying state of a loved one, but he is not obliged to conduct a conversation about the possibility of posthumous donation. It turns out that the relatives of the deceased (dying) person should raise this issue on own initiative. Needless to say, in most cases they are not able to do this (due to lack of awareness or due to severe emotional state). In addition, the relatives of the deceased may have different views on posthumous donation, and the law does not explain which opinion should be decisive for the doctor. In such a situation, conflicts are inevitable that harm both the medical staff and the relatives of the deceased.

Rules for diagnosing the death of a donor

This point is spelled out in the law most clearly: organs can be removed only if a person has been diagnosed with brain death or biological death i.e. stop breathing and heartbeat. The fact is that brain death does not always mean the end of all vital functions organism: in conditions of resuscitation, heartbeat and breathing can be maintained with the help of equipment for several days.

The start time of the procedure for ascertaining brain death depends on the diagnosis and treatment that the patient received (in particular, on medicines given to him). To diagnose brain death, a special council should meet. Its members study the medical history and conduct research designed to determine the presence or absence of brain activity(computed tomography of the brain, checking the possibility of spontaneous breathing, etc.). The decision on brain death cannot be made earlier than after 6 hours of observation of the patient.

However, many transplantologists argue that this part of the legislation is also imperfect. It is enough that for the patients who were led sedatives(and this category includes almost all patients intensive care units), the procedure for diagnosing brain death should be delayed by at least 20 hours. According to doctors, during this time, decay processes begin in the body, and by the time a decision is made on the possibility of removal, the organs already become unsuitable for transplantation.

Lifetime donation

Russian legislation provides for the possibility of lifelong related donation. It is not forbidden to transplant an organ or tissue to a child, brother or sister, one of the parents (but not the husband or wife).

Opportunity to buy organs

Paid organ donation is completely prohibited in Russia. All offers of this kind are criminal.

Donation for HIV

faces, virus-infected human immunodeficiency are not eligible to become donors. This prohibition applies to patients viral hepatitis B and C, as well as on patients with malignant neoplasms.

Unidentified donors

The removal of organs from people who could not be identified after death is prohibited. The reasons for the ban are not related to either medical or moral and ethical considerations. Lawyers refer to the legislative norm, according to which only Russians can become donors, and it is not possible to determine the citizenship of a person who died unidentified.

Child donation

Until recently, little Russians who needed a transplant of donor organs could only count on the help of foreign clinics. Harvesting of organs from deceased children was not prohibited, but was practically not carried out, since the procedure for diagnosing brain death in such patients was not regulated by law. In 2015, this omission was corrected, and doctors were able to remove organs from patients who died between the ages of 1 and 18. Of course, these procedures can only be carried out with the informed and written consent of the parents of the deceased.

The attitude of the majority of Russians towards posthumous donation can be described as negative. According to the results of sociological surveys, about 20% of our fellow citizens do not want to bequeath their organs for transplantation for religious reasons, although not one of them official religions donation is not condemned. Particularly alarming is the fact that almost 40% of respondents are hesitant to consent to post-mortem organ harvesting for fear that their will will cause dishonest provision medical services or in general will provoke criminal actions of doctors.

Obviously, the reason for such an attitude to an extremely important problem is the imperfection of the legislation. Since 2015, there has been a draft law “On donation of human organs and their transplantation”, prepared by the Ministry of Health, but still not considered by the State Duma of the Russian Federation. This document partly fills in the gaps in the legislation. For example, it contains provisions on the organization of a federal register of wills of potential donors, the absence of which prevents the use of even those disabilities which are now available to domestic transplantologists. The creation of an all-Russian register of recipients is also expected (today, doctors have only regional waiting lists). However, according to experts, this draft law also contains norms that will not only ease, but complicate the situation of patients in need of transplantation. In particular, the kidney is again not included in the list of organs allowed for removal, namely, its transplantation is indicated a huge number sick.

The number of people in need of organ transplants will always exceed the number of potential donors. In our country, this problem is especially acute, and its solution, unfortunately, is a matter of a very distant future.

Video from YouTube on the topic of the article: