Not death, but a second life!
We have repeatedly touched upon the topic of the transplant system in Ukraine, but mostly in terms of plans for the future. And finally, in the realities of today, we can observe not just encouraging news in this field of medicine, but truly viable. We can already see that the transplant system is not easy to be unambiguous, it already exists, and it is already taking at least the first, but surprisingly confident steps. How can this be seen? No, not from medical statistics and not from medical journals, which, as if on the tablets of history, record the dates of transplant operations. First of all, it can be seen in the sparkling eyes of people who were one step away from death, life-lovers, to whom artists-artists completed the lines of life.
How did it all start?
In autumn 2019, Cherkasy region developed and approved the regional program "Transplantation of autologous hematopoietic stem cells of bone marrow and peripheral blood" for 2019-2023 , which provided for the establishment of the Regional Oncology Center Dispensary Autologous Transplantation.Thanks to the approved regional program, the necessary high-quality equipment was purchased and the premises were prepared. Doctors received practical training at the Center for Hematological Transplantation of the Chemotherapy and Hematology Clinic of the University Clinic in Riga, Latvia. Colleagues from Latvia were also invited and helped the dispensary doctors to carry out the first procedures to prepare cells for transplantation (stem cell separation and cryopreservation). At the end of November 2019, Cherkasy doctors performed autologous bone marrow transplantation for the first time in the region, ie transplantation of the patient’s own cells. The patient is currently discharged and is under medical supervision. Physicians will continue to develop the program, in 2020 it is planned to conduct up to 40 such transplants. Prior to that, such operations were performed only in Kyiv and Lviv. At the same time,
Transformation in the legal framework
In early December 2019, the Verkhovna Rada of Ukraine voted in the first reading for amendments to the Law on Transplantation . This made it possible to successfully adopt several important bills in late December to build a comprehensive transplant system and approve a pilot project. Thanks to this, ten participants of the pilot transplant project, who submitted the relevant applications and approved by the Resolution of the Cabinet of Ministers of Ukraine of December 18, 2019 № 1083"On approval of the list of services and tariffs for tertiary (highly specialized) medical services by transplantation of organs and other anatomical materials provided to participants of the pilot project to change the mechanism of financial support for surgical treatment of transplantation of organs and other anatomical materials"
According to the Ministry of Health of Ukraine, the payment was made from the State Budget for 2019. After the use of these funds, an additional transfer of funds from the State Budget 2020 will be made in order to fully cover the costs of transplant operations taking place in Ukraine. This step Dmytro Koval “One of the key characteristics of the system we are building , Deputy Minister of Health of Ukraine, commented on is rules that are the same for everyone. The patient must receive a service of appropriate quality in each institution that performs transplant operations. All institutions that want and can do this should be able to perform transplants. Payment for transplant services should be made regardless of regional affiliation at the same rates for all. In order to receive payment for transplant services, institutions do not need to "pad" the thresholds of the ministry or be members of various working groups - you just need to meet the criteria. "
The list of medical institutions has been increased
Given the urgent need to increase the number of transplant operations, the Cabinet of Ministers of Ukraine has expanded the list of health facilities that are participants in the pilot project, have a license for transplantation and are ready to perform transplant operations. In particular, the following: KZ "Dnepropetrovsk Regional Clinical Hospital . VI Shapoval », Kharkiv; Kovel City District Territorial Medical Association of the Kovel City Council of the Volyn Region, Kovel; State Institution "Heart Institute of the Ministry of Health of Ukraine", Kyiv; state institution "National Institute of Cardiovascular Surgery. MM Amosov of the National Academy of Medical Sciences of Ukraine ", Kyiv; Cherkasy Regional Oncology Dispensary, Cherkasy Regional Council, Cherkasy.
. II Mechnikov ", Dnipro; KNP of the Lviv Regional Council "Lviv Regional Clinical Hospital", Lviv; KNP "Odesa Regional Clinical Hospital" of the Odessa Regional Council, Odesa; KNP Kharkiv Regional Council "Kharkiv Regional Clinical Center of Urology and Nephrology
Based on the results of the pilot project in the first quarter, the Ministry of Health of Ukraine will conduct an analysis and possibly expand the list of participants in the pilot project.
2020 - launch of a comprehensive transplant system
On December 20, 2019, the Verkhovna Rada of Ukraine adopted Bill 572457, which will introduce a comprehensive transplant system in Ukraine. According to this Bill, a Unified State Information System for Organ and Tissue Transplantation will be created, which is currently being tested to eliminate shortcomings, establish and operate the registers of potential bone marrow donors.
From the beginning of 2020, Ukraine will start conducting organ transplant operations, which previously took place abroad and required significant public funds. Approximately from April 2020, doctors will be able to use the Unified State Information System for Transplantation of Organs and Tissues in the experimental mode, and the transplant operations themselves will be carried out in the usual mode. The date of launch of the system for mandatory use is set from January 2021 . Dmytro Koval notes: “Our goal is not one or five operations, but a system in which hundreds can be done, a system in which every step will be transparent, understandable and will not cause doubt in people. After all, in 2020, every Ukrainian will have the opportunity to agree to donate and save lives - we hope that our society will support this global approach.
It’s just beginning!
Probably the most significant and grandiose events in the newly launched Ukrainian transplant process after a 15-year break are the transplant of two hearts. Hearts beating again in new breasts. Everything happened within the walls of the district hospital in the town of Kovel in Volyn. The first transplant took place in late December, the second - in early February. Due to the skill and professionalism of the team of Kovel and Kyiv doctors led by cardiac surgeon Borys Todurov, both extremely complex operations were successful. The first patient, Vasyl Mihovka, has already been discharged home. Now he begins a new page in his life, a life when children have grown up and grandchildren have grown up - a life "for himself." The second patient, Sviatoslav Nimchuk, is also preparing for rehabilitation after a successful operation, which will take place at the Heart Institute in Kyiv. These two men received the most valuable thing - the opportunity to wake up and feel the beating of a healthy heart in his chest! Thanks to the donation, they got a chance for a Second Life!
Bless you!
Author Kateryna Stebelska
Read also: Unrestricted training with a guarantee of employment
How did it all start?
In autumn 2019, Cherkasy region developed and approved the regional program "Transplantation of autologous hematopoietic stem cells of bone marrow and peripheral blood" for 2019-2023 , which provided for the establishment of the Regional Oncology Center Dispensary Autologous Transplantation.Thanks to the approved regional program, the necessary high-quality equipment was purchased and the premises were prepared. Doctors received practical training at the Center for Hematological Transplantation of the Chemotherapy and Hematology Clinic of the University Clinic in Riga, Latvia. Colleagues from Latvia were also invited and helped the dispensary doctors to carry out the first procedures to prepare cells for transplantation (stem cell separation and cryopreservation). At the end of November 2019, Cherkasy doctors performed autologous bone marrow transplantation for the first time in the region, ie transplantation of the patient’s own cells. The patient is currently discharged and is under medical supervision. Physicians will continue to develop the program, in 2020 it is planned to conduct up to 40 such transplants. Prior to that, such operations were performed only in Kyiv and Lviv. At the same time,
Transformation in the legal framework
In early December 2019, the Verkhovna Rada of Ukraine voted in the first reading for amendments to the Law on Transplantation . This made it possible to successfully adopt several important bills in late December to build a comprehensive transplant system and approve a pilot project. Thanks to this, ten participants of the pilot transplant project, who submitted the relevant applications and approved by the Resolution of the Cabinet of Ministers of Ukraine of December 18, 2019 № 1083"On approval of the list of services and tariffs for tertiary (highly specialized) medical services by transplantation of organs and other anatomical materials provided to participants of the pilot project to change the mechanism of financial support for surgical treatment of transplantation of organs and other anatomical materials"
According to the Ministry of Health of Ukraine, the payment was made from the State Budget for 2019. After the use of these funds, an additional transfer of funds from the State Budget 2020 will be made in order to fully cover the costs of transplant operations taking place in Ukraine. This step Dmytro Koval “One of the key characteristics of the system we are building , Deputy Minister of Health of Ukraine, commented on is rules that are the same for everyone. The patient must receive a service of appropriate quality in each institution that performs transplant operations. All institutions that want and can do this should be able to perform transplants. Payment for transplant services should be made regardless of regional affiliation at the same rates for all. In order to receive payment for transplant services, institutions do not need to "pad" the thresholds of the ministry or be members of various working groups - you just need to meet the criteria. " The list of medical institutions has been increased
Given the urgent need to increase the number of transplant operations, the Cabinet of Ministers of Ukraine has expanded the list of health facilities that are participants in the pilot project, have a license for transplantation and are ready to perform transplant operations. In particular, the following: KZ "Dnepropetrovsk Regional Clinical Hospital . VI Shapoval », Kharkiv; Kovel City District Territorial Medical Association of the Kovel City Council of the Volyn Region, Kovel; State Institution "Heart Institute of the Ministry of Health of Ukraine", Kyiv; state institution "National Institute of Cardiovascular Surgery. MM Amosov of the National Academy of Medical Sciences of Ukraine ", Kyiv; Cherkasy Regional Oncology Dispensary, Cherkasy Regional Council, Cherkasy.
. II Mechnikov ", Dnipro; KNP of the Lviv Regional Council "Lviv Regional Clinical Hospital", Lviv; KNP "Odesa Regional Clinical Hospital" of the Odessa Regional Council, Odesa; KNP Kharkiv Regional Council "Kharkiv Regional Clinical Center of Urology and Nephrology
Based on the results of the pilot project in the first quarter, the Ministry of Health of Ukraine will conduct an analysis and possibly expand the list of participants in the pilot project.
2020 - launch of a comprehensive transplant system
On December 20, 2019, the Verkhovna Rada of Ukraine adopted Bill 572457, which will introduce a comprehensive transplant system in Ukraine. According to this Bill, a Unified State Information System for Organ and Tissue Transplantation will be created, which is currently being tested to eliminate shortcomings, establish and operate the registers of potential bone marrow donors.
From the beginning of 2020, Ukraine will start conducting organ transplant operations, which previously took place abroad and required significant public funds. Approximately from April 2020, doctors will be able to use the Unified State Information System for Transplantation of Organs and Tissues in the experimental mode, and the transplant operations themselves will be carried out in the usual mode. The date of launch of the system for mandatory use is set from January 2021 . Dmytro Koval notes: “Our goal is not one or five operations, but a system in which hundreds can be done, a system in which every step will be transparent, understandable and will not cause doubt in people. After all, in 2020, every Ukrainian will have the opportunity to agree to donate and save lives - we hope that our society will support this global approach.
It’s just beginning!
Probably the most significant and grandiose events in the newly launched Ukrainian transplant process after a 15-year break are the transplant of two hearts. Hearts beating again in new breasts. Everything happened within the walls of the district hospital in the town of Kovel in Volyn. The first transplant took place in late December, the second - in early February. Due to the skill and professionalism of the team of Kovel and Kyiv doctors led by cardiac surgeon Borys Todurov, both extremely complex operations were successful. The first patient, Vasyl Mihovka, has already been discharged home. Now he begins a new page in his life, a life when children have grown up and grandchildren have grown up - a life "for himself." The second patient, Sviatoslav Nimchuk, is also preparing for rehabilitation after a successful operation, which will take place at the Heart Institute in Kyiv. These two men received the most valuable thing - the opportunity to wake up and feel the beating of a healthy heart in his chest! Thanks to the donation, they got a chance for a Second Life!Bless you!
Author Kateryna Stebelska
Read also: Unrestricted training with a guarantee of employment