Hostages of the situation or what is happening today with family transplantation in Ukraine.
Every year in Ukraine about 2,000 people need transplants, a quarter receive help, and more than half of them - abroad. While the donor potential of the country is about 5 thousand donors annually. And this topic has been the subject of heated debate for some time.
In May last year, the Verkhovna Rada of Ukraine passed a bill "On Amendments to Certain Legislative Acts of Ukraine on Health Care and Transplantation of Organs and Other Anatomical Materials of Man", and the law came into force on January 1, 2019.
And since then, no transplants have been performed in the country.
We will not list articles of the law, names and numbers of bylaws within the limits of this material, but we will tell about essence. According to experts, the new law is quite similar to the previous one, which, although not implemented in all its manifestations, but regulated the basic relations in the field of transplantation. In other words, the creation of the Unified State Information System, the introduction of the profession of transplant coordinators, etc. were registered there, as well as in the current one, but these tools were never implemented.
From now on, it’s not just advice, these points are mandatory. In addition, the new law clearly defines the procedure for determining the "brain death" of potential inanimate donors. It seems that we are mentioning this in view of the topic of the article on family transplantation from a living donor. Have a little patience.
Are doctors to blame?
First of all, for a transplant today it is mandatory to register the recipient in the Unified State Information System, as well as information about all potential donors, including relatives. However, EDIST does not physically exist yet, and the law works. And non-compliance with the procedure from January 1 entails criminal liability. In other words, any doctor who agrees to perform a transplant operation, including a family one, is automatically subject to punishment.
There is a lot of discussion about this issue today. Lawyers in charge of medical affairs were divided into two camps. For example, Maryna Slobodnichenko, a legal adviser to the Ministry of Health of Ukraine, believes that the new law in no way restricts the possibility of conducting family (and sometimes cross) transplants. According to her (voiced at the conference "Current issues of transplantation and organ donation" on February 22 this year), the law regulates, on the one hand, the procedure for taking donor organs from inanimate donors, and on the other - the procedure for the actual transplant operation. which takes into account the voluntary consent of the living donor to collect material. And if there are indicators before the transplant, then the introduction of information to the EDIST is possible after its implementation.
On the other hand, Olena Babich, a medical lawyer, emphasizes (at the same event - author) that formally, according to the new law, "money in the morning - chairs in the evening", ie without registration of the donor and recipient in EDIST, the operation will be illegal and guilty.
At the recent specialized practical conference "Actual problems of transplantation and organ donation" her opinion was clearly and unequivocally confirmed by representatives of the Prosecutor’s Office, the Security Service, the Interior Ministry and other law enforcement agencies. public outrage): without entering the relevant data in the register, any transplant operation will be considered a criminal case. However, they clarified that the relevant structures in the process of its consideration, of course, take into account all the circumstances, needs of the patient, conditions and process of the operation, which means that such cases are unlikely to end in criminal punishment. But which of the doctors in such circumstances will take a conscious risk to "compete" with domestic law enforcement agencies ?!
What to expect now?
The new law was adopted in May last year, and by the beginning of 2019 it was planned to develop all regulatory documents, create an EDIST, train transplant coordinators and the full functioning of the authorized body for transplantation. And this despite the fact that experts have warned - time is short, such large-scale processes require a significantly longer period to run.
Activists are still waiting for the law to be postponed for at least a year in order to bring the transplant medical system in line with its requirements (not to mention the need to equip medical facilities and, above all, intensive care units with the appropriate equipment to determine brain death. without which the removal of donor organs is virtually impossible). However, the law came into force.
According to the Ministry of Health, progress has already been made in resolving the problems that have arisen. For example, work on creating the EDIST platform has started. But for some reason only now - the relevant agreements were signed only in December. The developers promise to create the system by the end of March so that the filling of the database will start in April and EDIST would work at least in test mode.
On the positive side
In December, an agreement was signed and access to the International Registry of Bone Marrow Donors was acquired. What this means for cancer patients should not be overestimated.
The first bone marrow transplant in Ukraine took place in 2000. Since then, the scientific and practical potential of domestic doctors allows to make similar interventions of any complexity. Oncology departments use modern protocols and new generation drugs (unless, of course, they are state-registered). However, many of their patients have to go for transplant to foreign clinics. Now there is hope to eventually build its own medical school for oncology transplantation.
Implementation of the state program of technical equipment of transplant centers began with four clinics - the capital’s Okhmatdyt, Shalimov Institute, Cancer Institute and Zaporozhye Regional Hospital. Again in December, a contract was signed for the purchase of modern medical equipment in these centers. We are waiting.
We can wait with you - and until the end of March, and before the election, and until the end of the year… But how long can wait for patients whose lives depend on timely transplantation? And a child with cancer, whose only salvation is a bone marrow transplant, and the bill has already gone to the bottom, if not for hours? It’s easy to chop off the shoulder, but shouldn’t you think first about those who find themselves under the very trunk that will soon fall on their heads?
Author Anna Stepanova (Stream Content Agency)
Read also: Childhood in a hospital bed. What should be done to make a child feel like a child even in a hospital bed?
Help the wards of the fund
In May last year, the Verkhovna Rada of Ukraine passed a bill "On Amendments to Certain Legislative Acts of Ukraine on Health Care and Transplantation of Organs and Other Anatomical Materials of Man", and the law came into force on January 1, 2019.
And since then, no transplants have been performed in the country.
We will not list articles of the law, names and numbers of bylaws within the limits of this material, but we will tell about essence. According to experts, the new law is quite similar to the previous one, which, although not implemented in all its manifestations, but regulated the basic relations in the field of transplantation. In other words, the creation of the Unified State Information System, the introduction of the profession of transplant coordinators, etc. were registered there, as well as in the current one, but these tools were never implemented. From now on, it’s not just advice, these points are mandatory. In addition, the new law clearly defines the procedure for determining the "brain death" of potential inanimate donors. It seems that we are mentioning this in view of the topic of the article on family transplantation from a living donor. Have a little patience.
Are doctors to blame?
First of all, for a transplant today it is mandatory to register the recipient in the Unified State Information System, as well as information about all potential donors, including relatives. However, EDIST does not physically exist yet, and the law works. And non-compliance with the procedure from January 1 entails criminal liability. In other words, any doctor who agrees to perform a transplant operation, including a family one, is automatically subject to punishment.
There is a lot of discussion about this issue today. Lawyers in charge of medical affairs were divided into two camps. For example, Maryna Slobodnichenko, a legal adviser to the Ministry of Health of Ukraine, believes that the new law in no way restricts the possibility of conducting family (and sometimes cross) transplants. According to her (voiced at the conference "Current issues of transplantation and organ donation" on February 22 this year), the law regulates, on the one hand, the procedure for taking donor organs from inanimate donors, and on the other - the procedure for the actual transplant operation. which takes into account the voluntary consent of the living donor to collect material. And if there are indicators before the transplant, then the introduction of information to the EDIST is possible after its implementation.
On the other hand, Olena Babich, a medical lawyer, emphasizes (at the same event - author) that formally, according to the new law, "money in the morning - chairs in the evening", ie without registration of the donor and recipient in EDIST, the operation will be illegal and guilty.At the recent specialized practical conference "Actual problems of transplantation and organ donation" her opinion was clearly and unequivocally confirmed by representatives of the Prosecutor’s Office, the Security Service, the Interior Ministry and other law enforcement agencies. public outrage): without entering the relevant data in the register, any transplant operation will be considered a criminal case. However, they clarified that the relevant structures in the process of its consideration, of course, take into account all the circumstances, needs of the patient, conditions and process of the operation, which means that such cases are unlikely to end in criminal punishment. But which of the doctors in such circumstances will take a conscious risk to "compete" with domestic law enforcement agencies ?!
What to expect now?
The new law was adopted in May last year, and by the beginning of 2019 it was planned to develop all regulatory documents, create an EDIST, train transplant coordinators and the full functioning of the authorized body for transplantation. And this despite the fact that experts have warned - time is short, such large-scale processes require a significantly longer period to run.
Activists are still waiting for the law to be postponed for at least a year in order to bring the transplant medical system in line with its requirements (not to mention the need to equip medical facilities and, above all, intensive care units with the appropriate equipment to determine brain death. without which the removal of donor organs is virtually impossible). However, the law came into force.
According to the Ministry of Health, progress has already been made in resolving the problems that have arisen. For example, work on creating the EDIST platform has started. But for some reason only now - the relevant agreements were signed only in December. The developers promise to create the system by the end of March so that the filling of the database will start in April and EDIST would work at least in test mode.
On the positive side
In December, an agreement was signed and access to the International Registry of Bone Marrow Donors was acquired. What this means for cancer patients should not be overestimated.
The first bone marrow transplant in Ukraine took place in 2000. Since then, the scientific and practical potential of domestic doctors allows to make similar interventions of any complexity. Oncology departments use modern protocols and new generation drugs (unless, of course, they are state-registered). However, many of their patients have to go for transplant to foreign clinics. Now there is hope to eventually build its own medical school for oncology transplantation.
Implementation of the state program of technical equipment of transplant centers began with four clinics - the capital’s Okhmatdyt, Shalimov Institute, Cancer Institute and Zaporozhye Regional Hospital. Again in December, a contract was signed for the purchase of modern medical equipment in these centers. We are waiting.
We can wait with you - and until the end of March, and before the election, and until the end of the year… But how long can wait for patients whose lives depend on timely transplantation? And a child with cancer, whose only salvation is a bone marrow transplant, and the bill has already gone to the bottom, if not for hours? It’s easy to chop off the shoulder, but shouldn’t you think first about those who find themselves under the very trunk that will soon fall on their heads? Author Anna Stepanova (Stream Content Agency)
Read also: Childhood in a hospital bed. What should be done to make a child feel like a child even in a hospital bed?
Help the wards of the fund