Donation after death. Is posthumous child donation allowed in Russia? Where to buy and sell a kidney

Currently, in a number of countries, most organs for transplantation are taken from brain-dead or living donors. In the United States, about 20,000 brain-dead donors are used each year for organ donation and transplantation.

Who can be an organ donor

Organ and tissue donors for transplantation can be:

1) living donors - closest relatives (identical twins, brothers, sisters, parents);

2) living donors who are not related to the recipient (relatives of the husband or wife, friends, close acquaintances);

3) dead donors - the corpses of people who suddenly died from cardiac arrest (biological death) and people with brain death, but with ongoing heart contraction.

The law clearly defines who can be an organ donor.

Dead donors with constantly beating hearts and organ perfusion are defined by the neurological criteria for brain death. Biological death is determined by cardiac criteria (complete cardiac arrest).

Who can be an organ donor: living and dead donors

living donor must be of age, fully conscious, able to make a decision voluntarily, without extraneous pressure. The donor must be physically and mentally perfectly healthy, capable of undergoing an organ removal operation without significant health risks. In a number of countries, transplantation of a kidney or 2-3 segments of the liver from those who can be an organ donor is performed quite often (40-60% from total number organ transplants).

In the case of further improvement of immunosuppressive therapy and an increase in the survival rate of transplanted organs, only the lack of cadaveric organs can justify the use of organs from living donors. In our country, taking an organ from a living donor who is not a close relative is prohibited for ethical and legal reasons.

Dead donors: distinguish between donors who died from cardiac arrest (biological death) and donors from brain death, but with a beating heart.

Donors with biological death it is necessary to perform cold preservation of organs as soon as possible after cardiac arrest in order to reduce the time of thermal ischemia, which causes degenerative changes in organs and sharply reduces the possibility of restoring normal function after organ transplantation.

Brain-dead donors are usually patients with severe traumatic brain injury or cerebral hemorrhage, in whom brain function is irreversibly lost while other bodily functions are maintained by intensive care. brain death, common consent scientists of most countries, is equated to the death of an individual.

Requirements for organ donors

The best option for transplantation is the presence of a healthy donor, aged 3 to 65 years, with an irreversible head injury or incurable cerebrovascular disease. With an extreme shortage of donor organs, some countries allow the use of organs from people with brain death over 65 years of age or from donors with biological death (with a non-beating heart). Donor history should be clarified and a thorough physical, laboratory and instrumental examination to identify diseases that are a contraindication to taking donor organs. These include generalized infection (including latent forms of HIV infection, viral hepatitis B and C), tumors (with the exception of non-metastasizing brain tumors). Hypertension and atherosclerosis are not a contraindication to organ donation.

Criteria for brain death in organ donors

brain death is established by a commission consisting of an anesthesiologist, a surgeon (neurosurgeon), a neuropathologist, a psychiatrist and an attending physician, according to established neurological criteria, after a double examination in a hospital with an interval of 6 to 12 hours. Loss of brain function is determined by:

1) by the lack of response to external pain stimuli, the presence of a deep coma, muscle atony;

2) by the absence of spontaneous breathing and cough reflex(including when changing the position of the endotracheal tube or the absence of irritation of the mucous membrane of the trachea and bronchi during sputum suction), spontaneous respiratory movements within 3 minutes after turning off the device artificial respiration;

3) by the absence of eye movements, corneal reflexes, pupillary response to light, the presence of wide pupils, isoelectric EEG (absence of brain activity);

4) by a steady decrease in body temperature. Gradually developed hypothermia with a body temperature below 32°C can be considered a reliable criterion. brain death;

5) to reduce blood pressure despite ongoing resuscitation (transfusion of solutions and administration of medicines for many hours).

The decision of brain death cannot be made if the patient is in deep hypothermia, severe hypovolemia, with cerebral edema, in a state of intoxication with depressants like barbiturates, because under these conditions a reversible isoelectric electroencephalogram can be observed.

Physicians in the transplant team should not be involved in the diagnosis of brain death. The rules for ascertaining the fact of brain death, neurological criteria and the procedure for taking organs from a donor are legally legalized in our country. If the deceased during his lifetime did not leave a will on consent to the removal of organs, then in the event of his sudden brain death, the consent of relatives is required for the removal of organs. The collection of organs for transplantation is carried out by a special team of doctors in the same medical institution where the death occurred.

Types of organ transplant operations

Special terminology is used to indicate the features of transplantation:

- autogenous transplantation- the donor and the recipient are the same person;

- isogenic transplantation- donor and recipient are identical twins;

- syngeneic transplant- donor and recipient are first-degree relatives;

- allogeneic transplant - donor and recipient are of the same species (for example, human-to-human transplant);

- xenogenic transplantation- donor and recipient belong to different species (for example, a transplant from a monkey to a person).

The term is used to refer to the transplantation of an organ to its usual place. orthotopic transplant. When an organ is transplanted to any other anatomical site, they speak of heterotopic transplantation.

If the severed organ or torn off part of the body is re-implanted into the host's body, then such an operation is called replantation.

Alloplastic transplant replacement of an organ or tissue with synthetic materials.

State and federal laws require that relatives of patients whose organs could potentially be used for organ harvesting be notified. Facts that can be shared with relatives to better understand the donation process:

1. each and all organs suitable for donation can be listed individually or excluded from donation
2. organ retrieval can be done in such a way that there is no change appearance deceased
3. relatives can receive information about the final use of any of the organs taken

Criteria for eligibility for organ harvesting

General criteria for excluding the possibility of organ retrieval:

1. infection
A. untreated septicemia
B. the following infections and diseases: AIDS, viral hepatitis, viral encephalitis, Guillain-Barré syndrome
C. current I/O usage narcotic drugs
D. active TB

2. malignant tumor(except primary brain tumor located within the cranial vault)

3. relative contraindications: chronic treated arterial hypertension, hypotension (preferably SBP >100 and normal CVP)

4. disease of organs intended for donation

5. Anacephalic newborns: according to modern generally accepted ideas, the brain stem is functioning in them (for example, there are spontaneous respiratory movements), which makes the diagnosis of brain death inapplicable in this situation (moreover, only a small number of such organs can be used for the benefit of other people)

These recommendations are constantly being reviewed, in particular due to best results use of cyclosporine in recipients. In general, consultation with a transplant consultant is recommended to determine the suitability of organs for donation.

1. brain death in a previously healthy patient

2. Bodies:
A. kidneys: age 6 months - 70 years. Normal blood pressure, urea, creatinine and urinalysis. Absence of systemic lupus erythematosus (due to the threat of lupus nephritis)
B. heart and heart/lungs: ideal age <35 лет для % и <40 для &(забор возможен в возрасте до 60 лет в зависимости от состояния сердца и потенциального реципиента). Обследование кардиологом для исключения сердечной патологии (кардиомиопатия, поражение клапанов, сниженная фракция выброса, тяжелое атеросклеротическое заболевание сердца, состояние после аорто-коронарного шунтирования). Отсутствие инсулин-зависимого сахарного диабета
C. liver: age 1 month - 60 years. Normal hepatic function [normal or acceptable AST, ALT, LDH, bilirubin (total, direct and indirect), clotting factors] with no indication of previous liver disease
D. pancreas: age<60 лет. Нет указаний на диабет в анамнезе. Нормальные показатели глюкозы и амилазы в плазме крови

3. Fabrics:
A. Cornea: ≥1 year. Neither cancer nor sepsis rule out sampling (tetanus and Creutzfeldt-Jakob disease are contraindications)
B. skin: age 15-65 years old. Cannot be taken with cancer
C. bones: age 15-65 years. Cannot be taken with cancer
D. Bone marrow: age ≤50 years
E. Heart valves: age ≤55 years old

Arrangements for organ harvesting after brain death

Note: after the onset of brain death, cardiovascular instability (x 3-5 d) is usually observed, for the correction of which pressor drugs are required. Disturbances in water and electrolyte balance resulting from loss of hypothalamic regulation can be compensated. In some cases, the maintenance of cardiac activity in such a deceased organism is possible for x months.

1. consent: must be obtained from the legal representative of the patient. NB: Must also be obtained from the Medical Examiner in cases where he participates in the examination (in most states this applies to accidental deaths x 24 hours after hospitalization, etc.)

2. A signed entry in the medical history about the date and time of registration of brain death

3. contact your transplant coordinator as soon as possible

4. If possible, stop (or reduce) the dose of vasopressors. Hypotension should be controlled by increasing the BCC whenever possible (after brain death, ADH production ceases, which leads to the development of diabetes insipidus with a large amount of urine, so the introduction of a large amount of fluid is justified (usually> 250-500 Most centers prefer not to administer exogenous ADH [vasopressin (Pitressin®)] whenever possible, due to the increased risk of kidney failure with brain death.

5. start with crystalloids (5% glucose solution with ¼ FR + 20 meq KCl/l is usually justified as it replaces free water); replace urine output accordingly (same amount + 100ml/h to maintain)

6. use colloids (FFP, albumin, etc.) if BP cannot be maintained by simple fluid replacement

7. If blood pressure is still low (hypotension), use vasopressors. Start with a small dose of dopamine, increasing it up to ∼10 µg/kg/min; if BP is still low at this dosage, add dobutamine

8. If after all of the above measures, urine output is still >300 ml/h, start administering an aqueous solution of vasopressin (Pitressin®), an ADH analogue considered to be preferred over DDAVP, to avoid kidney shutdown

9. IV thyroglobulin promotes a change in the anaerobic metabolism of some cells to aerobic, which can help avoid cardiovascular collapse

Laboratory diagnostics

General Initial Research

1. serology: analysis for syphilis, hepatitis, HIV, blood type, tissue typing for human leukocyte antigens

2. biochemistry: electrolytes, glucose, urea, creatinine, calcium, phosphate, liver values, urinalysis

3. blood test: general analysis, indicators of the coagulation system

4. microbiology: blood, urine and sputum cultures, Gram smear

Kidney donation

1. in addition to basic tests, check creatinine and urea daily
2. check electrolytes every 12 hours (more often if necessary)

Liver donation

1. in addition to the basic tests (see above), check AST, ALT, LDH, bilirubin (total, direct and indirect)

Heart donation

1. in all cases, an echocardiogram is required before sampling

Greenberg. Neurosurgery

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 in silence. But for some signs, you can suspect problems with them:

swelling of the eyelids, hands, ankles due to fluid retention;
pain in the 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. This is a paired organ, so the functions of one can be performed by the other.

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.

It is forbidden to take the organ until the final results of the analyzes and tests have been received. Possible risks during the operation are determined.

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 - if infectious diseases, HIV, hepatitis, tumors, ischemia are detected, doctors will not allow you 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. Specialists examine him and conduct secondary tests: ultrasound, echocardiography of the heart, x-rays 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 in 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 a high price, and the highest prices are in Moscow, where they will ask for $10,000 or more.

Organs are cheaper in small towns with low salaries and low prices. 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 administers general anesthesia to the donor. After that, a catheter is connected (cleanses the 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, ureters are excised, then clamped. Wounds are sutured and a sterile bandage is applied.

Quite rarely, in this case, an abdominal operation is performed. 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 the 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. He can lead an active life in a year. Women are not allowed to give birth afterwards.

The life of donors is similar to the life of ordinary people: the usual way of life, everyday 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.

Not all diseases are curable. But in some cases, an organ transplant gives hope for recovery. This method of saving a person was first used in the middle of the 20th century. Transplantology is still a very young field of medicine. Transplantation of internal organs is now quite a common operation. Each country has certain laws that determine the legality of this procedure. Consider further organ donation in Russia and the world. How does this happen?

What is a transplant and when is it needed?

Let us first define what transplantation means. The procedure is a healthy organ transplant from one person to another. It can be needed not only for an adult, but also for a child. This whole process can be divided into two stages:

Explantation of an organ or organs from a donor.
Implantation of an organ into the recipient's body.

There are many reasons why this operation may be necessary.

Let's name some of them:

Leukemia or lymphoma require a bone marrow transplant.
Some cancers.
Heart diseases.
Liver diseases.
Diseases of the kidneys.
Lung diseases.
Diseases of the gastrointestinal tract.

It is organ transplantation that in some cases saves a person's life. The law on organ donation in Russia helps to solve this problem.

Who can become a donor

Man is the source of organ transplantation. Donation can be:

Posthumous.
Voluntary lifetime.

The law on organ donation in Russia defines the categories of persons who can become donors during their lifetime. These are persons who have reached the age of majority. What conditions must be met:

The decision must be made by the person himself without pressure from outside.
The donor must be mentally and physically healthy.

For a bone marrow transplant, the donor must be under 18 years of age. Also, a blood relative can be a donor, for example: brother, sister, mother, father.

Most often, posthumous donation is used. This process is regulated by law and supported. How does organ donation work in Russia? More on this later.

I would like to note that any person who has no contraindications to this procedure can become a bone marrow donor. There is an all-Russian database of bone marrow donors. To enter it, it is enough to pass an analysis for typing. You might save someone's life.

Donation in Russia after death

There is a presumption of consent to organ donation in Russia. This means that any deceased citizen is a donor. Everyone has the right to give their consent or not to give it to organ transplantation after death. The statement can be read orally, in the presence of two persons or in writing. The paper must then be certified by a notary. If the process takes place in a hospital, the application can be certified by the head physician.

But (unlike other countries) in Russia there is no register of such expressions of will yet. Such a system is very weak and not very efficient.

It is worth noting that posthumous organ donation in Russia also has its drawbacks. So, if the deceased did not leave consent to donation after death, then relatives have the right not to agree to transplantation. At the same time, the doctor is not obliged to discuss this topic with relatives. So, relatives should raise and resolve this issue themselves.

Who can't be a donor

There are absolute contraindications to donation. These include the presence of such diseases:

Human immunodeficiency virus type 1 and 2.
malignant formations.
Primary brain tumor.
Infectious-septic complications in a potential donor.
disseminated infection.
bacterial sepsis.
Generalized fungal infection.
active tuberculosis.
Meningitis.
Fungal colonization of the lungs.

Organs cannot be removed from unidentified deceased citizens, as well as from foreign citizens.

Examination of a potential donor

A person can become a donor after death if at least one organ is suitable for transplantation.

The survey evaluates:

condition of all organs.
Lifetime risk factors.
Absolute and relative contraindications.

Considered:

Causes of death.
The age of the deceased.
High risks. They can be the reason for refusal to donate.
Lifetime diseases. In the presence of diabetes mellitus or hypertension, the degree of organ damage is determined.

Conduct a physical examination of the donor:

If tattoos made less than three months ago are detected on the body, infection with an infectious virus is possible. The donation may be cancelled.
Availability of places from injections. May talk about drug use.
Surgical scars. It is important to know the reasons for surgery.
Physical examination of the skin to detect neoplasms on the skin.

Conduct biochemical studies, a complete blood count. Mandatory are tests for the determination of antibodies to HIV, hepatitis C, hepatitis B and many others.

Donor death setting

Organ donation in Russia after death is possible only after brain death is declared. The law specifies the obligatory observance of this clause.

To ascertain brain death, a special commission is needed. It should include:

Neurosurgeon.
Anesthetist.
Neurologist.
Psychiatrist.
Attending doctor.

The examination should be carried out twice (with an interval of 6 to 12 hours).

Brain death is defined by the following signs:

No response to external pain stimuli.
deep coma.
Muscle atony.
No spontaneous breathing within 3 minutes after turning off the artificial respiration apparatus.
There are no corneal reflexes.
The pupils do not react to light.
The eyes don't move.
Reduced blood pressure during resuscitation.
Body temperature drops below 32 degrees. Hypothermia gradually develops.

If there is doubt about brain death, an electroencephalography of the brain should be performed.

It is impossible to state death if a person is in deep hypothermia, with severe intoxication with depressants, with cerebral edema, and also with severe hypovolemia.

Organ conservation

After the establishment of brain death, the task of doctors becomes to support blood circulation and respiration in the body of the donor until the necessary organs are removed. Once removed, they can easily die from the heat. So, the heart can withstand 20 minutes, the kidneys - 45 minutes, and the pancreas - 30 minutes. The donor's body can be connected to a perfusion machine, washed from the blood. Further, using special solutions, the body will be conserved. In such cases, all organs can be taken from the donor. But the time of cold ischemia is also limited for the body. The shorter it is, the better for the organ.

Currently, methods of modern preservation allow preserving organs from 24 to 36 hours. Least of all, it is possible to save the lungs and heart (only 6 hours), but this is enough to save someone's life.

The law on organ donation in Russia provides for lifetime donation. As a rule, this is the removal of paired organs:

Kidneys.
Part of the liver.
Part of the small intestine.
Share of the lung.
Part of the pancreas.
Bone marrow.

Organ donation in Russia is voluntary for relatives:

sisters
Brother.
Daughters.
Son.

Husband or wife cannot be donors for each other. In this case, no compensation is provided by law. In addition, it is indicated that the sale of human organs and tissues is inadmissible.

First of all, it is necessary to formalize the consent of the donor, which must be accepted without pressure from the outside. An agreement is drawn up on the removal of organs or tissues between the medical institution and the donor. A person who donates his organ has the right to know about all possible complications in connection with the upcoming operation.

The donor undergoes a medical examination:

Doctors must state that the transplantation will not cause irreparable harm to health.
It must be confirmed that there are no contraindications to donation.
Biological compatibility with the recipient is checked.
The possible consequences for the donor and recipient are being studied.

An agreement is also concluded between the medical institution and the recipient on the transplantation of organs to the latter in order to save life.

How to sell an organ for donation in Russia

It is impossible to sell an organ officially in Russia, just like buying it. In addition, it is a criminal offence. Organ donation in Russia is voluntary.

There are similar ads in the newspapers, which, of course, are not legal. But by agreeing to tempting conditions, you will fall into the hands of charlatans. They will not be able to guarantee the safety for your health or the necessary organ compatibility for your loved one. You will lose time, money and the most valuable thing - your health, if you agree to a transplant.

Many people consider organ trafficking to be unethical. Also, most religions are against transplantation, all the more negatively about organ trafficking. Based on this, organ donation in Russia and transplantation occur only on a voluntary basis.

More recently, organ harvesting from deceased children has not been carried out. The legislation did not contain a procedure for diagnosing brain death in young patients. This was corrected in 2015. Now the law regulates the removal of organs from the dead from 1 to 18 years. The written consent of the parents is required.

I would like to note that posthumous child organ donation in Russia gives hope to many parents for the recovery of their child. It is necessary for heart and liver transplantation. There have been cases when the parents of a dying child would like to help other needy children.

The debate about whether the law needs to be improved is ongoing. Competent experts believe that everything is taken into account in it. Some are of the opinion that it is necessary to allow the sale of organs at the official level.

Organ donation in the world

In most civilized countries, as in Russia, there is a presumption of consent. But there are countries where you can buy an organ or sell it quite legally. These are such states as Pakistan, Colombia, India, Philippines. The cost of a kidney may exceed 100 thousand dollars (5.6 million rubles). Tourists who agree to transplants get only a few thousand.

In Pakistan, husband and wife are considered blood relatives. Women have very few rights and, as a rule, in 95% of cases, a donor organ is taken from a wife, daughter or sister. In these countries, pre-transplant screening is not carried out at the highest level. The kidney may be infected, then the recipient is organ rejection with possible blood poisoning.

People who agree to sell their organ most often do not have any extracts in their hands that would confirm the surgical intervention.

In Pakistan, selling organs is an opportunity to make money.

Spain ranks first in organ transplantation. There is a presumption of consent in this country. Relatives are delicately asked and, as a rule, they are not refused. They are interviewed first. Donation in this country is considered the norm. Each hospital has specially trained staff, specialists and equipment.

Organ donation in Russia after death is rare. First, there are very few hospitals equipped with the necessary equipment. In addition, our population tends to not give consent due to poor awareness, so donation is still not developing at the required level.