7 important questions about transplantology in Ukraine: expert answers

Transplantology in Ukraine © depositphotos.com

56-year-old Vasily Migovka, a patient of Boris Todurov, cheerfully entered the studio “Concerns everyone”. More recently, it was hard for a man to walk and even lie down, he was suffocating and was very weak. Only a heart transplant could help Vasily. His family – his wife and five already adult children – were ready to sell everything in order to collect the necessary amount for operations abroad. But that would not be enough.

Heart transplantation abroad is very expensive – starting from 100 thousand dollars and above. The cheapest in Belarus is $ 100 thousand, and, except Belarus, no other country in the world takes our citizens. But not every person has such an amount. People sell property, take loans. Someone is lucky, he gets on the line at the Ministry of Health, but there you need to wait until the line comes up. Then – wait until a donor organ suitable for compatibility appears. Bodies are automatically selected by a computer system. Therefore, very few people get this chance for life. Our country is losing the most valuable that it has – our citizens. A lot of people give up, give up and die, explains the head of the National Movement "For Life" Yuri Andreev.

Transplantology in Ukraine Boris Todurov and Vasily Migovka © Inter Channel Press Service


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Vasily Migovka was lucky. Donor organ appeared in Ukraine. The man stood third in line for a heart transplant. And when the information came that there is a donor, a new heart came up to him in all respects. Basil agreed without hesitation. The operation was carried out in the city of Kovel in Volhynia, and the next day the patient was taken to the Kiev Heart Institute. Now the man is losing weight to make it easier for his new heart to “work,” he is taking drugs on a clear schedule and thanks his savior.

In the “Affects Everyone” studio, Boris Todurov answered questions about transplantology in Ukraine.

Why hasn’t there been heart transplant operations in Ukraine for 15 years?

Boris Todurov Boris Todurov director of the Heart Institute expert opinion This is a complex problem. Firstly, our legislation is imperfect. Secondly, the chief physicians, resuscitation doctors do not have enough motivation to preserve the donor, determine brain death, spend certain reagents, their time and energy on this, since this only leads to an increase in problems: the prosecutor’s office, the police, various inspection organs after transplantation start checking. You know that several years ago there was a high-profile criminal case regarding transplantologists, which practically did not end there. After a year and a half of imprisonment in a pre-trial detention center, they were simply released. And that threw off our transplantology several years ago. Everyone was just afraid to do it.

Why was the first heart transplant operation not in Lviv or Kiev, but in Kovel?

Boris Todurov Boris Todurov Director of the Institute of Hearts expert opinion Unfortunately, in Kiev, none of the hospitals gives us the opportunity to take organs from dead people. Although formally, many of them are bases for the collection of organs. It so happened. But a big transplant enthusiast, Oleg Olegovich Samchuk, appeared in Kovel. He bought the necessary equipment, made repairs in the operating room, brought in a heart-lung machine from Poland, received a license for cardiac surgery and, when a donor appeared, called us …

How long can donor organs last?

Boris Todurov Boris Todurov Director of the Heart Institute, expert opinion. The heart is very sensitive to oxygen starvation, therefore, only three hours can live outside a living organism. Just like the liver, the lungs – 3-3.5 hours. If during this time the heart is not sutured, blood flow through the coronary vessels is not allowed, it simply dies. And to save it longer than this time in Ukraine is also impossible. Therefore, the question of the proximity of the donor and the recipient is the most important from the point of view of transplantation organization. We can afford to transport the heart for no more than an hour. Because the preparation and suturing procedure itself takes an hour and a half. And when time approaches 2.5 – 3 hours outside the body – this is ischemia, it is already critical. At the first transplants that we did in the 2000s, there were donors whom we carried within the city. Even a big traffic jam can be circled for an hour somehow. Nearby cities within 50-70 km around Kiev are also possible, from which we can deliver organs within an hour. Of the settlements that are located territorially further from Kiev, at a distance of 200-300 km, it is possible only by helicopter. We have a platform on the roof of the clinic where we can land a helicopter up to 12 tons. That is, almost any helicopter that is in the Ministry of Emergencies.

Is it possible to protect yourself from "black transplantologists" and how exactly?

Boris Todurov Boris Todurov director of the Heart Institute expert opinion In Ukraine there is no black transplantology. I declare to you responsibly. If someone goes abroad to sell something underground, yes. In Ukraine, controlling everything is very simple today. Transplant centers can be counted on the fingers of one hand. Each operation involves dozens of people. And after the patient you need to nursing under the supervision of doctors. What dozens of people know is impossible to keep secret. And all this is fantasy – about black transplantologists and the fact that someone found some jars where it was written "heart", "liver", "lungs" … Someone got into a fantasy. And that's bad. Abroad, a child from childhood is formed the concept of transplantology as a science of saving lives. It is formed by the state, money, forces and funds are invested in it so that people have the correct idea of ​​transplantology in general.

Transplantology in Ukraine Boris Todurov © Inter Channel Press Service

How is the decision to take organs taken today?

Boris Todurov Boris Todurov Director of the Institute of the Heart expert opinion The death of a brain is equated with the biological death of a person. Our life is the life of our brain. After the brain has stopped living, the heart still beats for a while, because it has its own rhythms. And if at this time to maintain artificial ventilation of the lungs, then for several hours, and sometimes days, the body of this person can live with a beating heart. During this time, as a rule, tests for the presence of viruses are carried out, the state of internal organs is determined. Several samples are being made that confirm brain death. Moreover, the death of the brain is confirmed by the commission, which consists of many specialists, and this is done twice over a certain time. And if twice experts confirmed the death of the brain, then you can talk with relatives and ask them for permission to harvest organs. This is always a dramatic situation. As a rule, a person died unexpectedly: some kind of accident happened or an aneurysm in his brain exploded. Imagine: in the morning, parents and their son drank tea at breakfast, and by lunch they were asked permission to harvest organs. Therefore, most often, of course, we get a refusal. Human lifetime consent facilitates the task. This is called a presumption of consent. According to this law, they live in Belarus, in Austria, in Germany …

How can one agree to become a donor in Ukraine?

Boris Todurov Boris Todurov Director of the Institute of the Heart expert opinion Now those who receive a passport can enter their consent to the posthumous organ transplantation there. But in Ukraine only 300 thousand of such passports are issued per year. And a critical mass of people who will give their consent in vivo to donation in life will only be gathered in 10 years. The law states that the consent fits either in the passport or in the law. For those who have previously received a passport or rights, the consent mechanism is not registered. I gave public consent in the event of death to harvest organs to save the lives of others. By the video message that I posted on social networks, I just wanted to say that I trust Ukrainian doctors. What do I trust Ukrainian transplantologists. I trust Ukrainian resuscitators who will ascertain the death of the brain.

Does it make sense to draw up such consent to a person aged with a bunch of diseases?

Boris Todurov Boris Todurov Director of the Heart Institute expert opinion I will give an example. When the Israeli Prime Minister, who was over 80, died, he did not have healthy organs. But they took the cornea from him and transplanted it to a girl who had a problem with the cornea. I know that in Ukraine there is a huge fear of transplantation. But the realities of life are such that you are 10 times more likely to become a recipient than a donor. Had the flu. In a month – myocarditis, in three months you are already waiting for a heart transplant on a waiting list …

This is exactly what happened with an absolutely healthy boy – 13-year-old Bogdan Khorolsky from the Dnipropetrovsk region. He had the flu, and when he went to school, he felt bad: the flu gave a heart complication. Now Bogdan is fighting for the opportunity to survive until transplantation. Doctors already several times after stopping started his heart. Without a "mechanical heart", an apparatus worth more than 5 million hryvnias, its chances of surviving a transplant tend to zero. This is said by Boris Todurov. Both the well-known heart surgeon and the team “Concerns everyone” turn to all concerned Ukrainians with a request to help Bogdan survive.

A donation can also be made on the website of the Serce na dolonі charity foundation. To do this, click the "Donate" button and in the line "Applied Payment" indicate "For Bogdan Khorolsky."

Transplantology in Ukraine Bogdan Khorolsky © Inter Channel Press Service

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