“Concerns everyone”: 7 important questions about transplantation in Ukraine

56-year-old Vasily Migovka, who underwent a heart transplant, briskly entered the “Affects everyone” studio. More recently, it was difficult 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 grown children - were ready to sell everything in order to collect the necessary amount for an operation abroad. But even that would not have been enough.

Yuri Andreev, head of the National Movement For Life, says:

Heart transplantation abroad is very expensive - starting at $ 100,000. dollars and above. The cheapest is in Belarus - $ 100 thousand, and, apart from Belarus, our citizens are not taken by any other country in the world. But not every person has that amount. People sell property, take loans. Someone is lucky, he gets on the line at the Ministry of Health, but there you have to wait until the line comes up. Then - wait until a donor organ appears that is suitable for compatibility. The organs are automatically selected by a computer system. Therefore, very few people get this chance at life. Our country is losing the most valuable thing it has - our citizens. A lot of people give up, give up and die.

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Vasily Migovka was lucky. The donor organ appeared in Ukraine.

The man was the third in line for a heart transplant. And when the information came that there was a donor, the new heart suited him in all respects. Vasily agreed without hesitation. The operation was carried out in the city of Kovel in Volyn, and the next day the patient was taken to the Kiev Heart Institute. Now the man is losing weight to make it easier for the new heart to “work”, takes medications on a clear schedule and thanks his saviors.

At the Affects Everyone studio, Boris Todurov answered questions about transplantation in Ukraine.

1. Why haven't there been heart transplants in Ukraine for 15 years?

This is a complex problem. First, our legislation is imperfect.

Secondly, the chief physicians, resuscitators do not have enough motivation to preserve the donor, determine brain death, spend certain reagents, time and effort, since this only leads to an increase in problems: the prosecutor's office, the police, various inspection bodies after transplantation begin checks. You know that a few years ago there was a high-profile criminal case concerning transplantation, which practically ended in nothing. After a year and a half in jail, they were simply released. And this put our transplantation back several years ago. Everyone was just afraid to do it.

2. Why did the first heart transplant operation take place not in Lviv or Kiev, but in Kovel?

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 organ harvesting. It happened so. But a great enthusiast of transplantation, Oleg Olegovich Samchuk, appeared in Kovel. He bought the necessary equipment, made repairs in the operating room, brought a heart-lung machine from Poland, received a license for cardiac surgery, and when the donor appeared, he called us... "

3. How long can donor organs be saved?

The heart is very sensitive to oxygen starvation, so it can "live" outside a living organism for only three hours.

Just like the liver, the lungs take 3-3.5 hours. If during this time the heart is not sewn in, blood flow through the coronary vessels is not allowed, it simply dies. And it is also impossible to keep it longer than this time in Ukraine.

Therefore, the question of the proximity of the donor and recipient is the most important from the point of view of the organization of transplantation.

We can afford to transport the heart for no more than an hour.

Because the very procedure of preparation and sewing takes an hour and a half. And when the time approaches 2.5 - 3 hours outside the body, this is ischemia, this is already critical. During the first transplants, which we did in the 2000s, there were donors whom we took within the city. Even a large traffic jam can somehow be bypassed within an hour. Also nearby cities are possible within 50-70 km around Kiev, from which we can deliver organs within an hour. From settlements that are geographically farther 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, practically any helicopter that the Ministry of Emergency Situations has ”.

4. Is it possible to protect yourself from “black transplant” and how exactly?

There is no black transplantation in Ukraine. I declare to you responsibly. If someone goes abroad to sell something underground, yes. It is very easy to control everything in Ukraine today. Transplant centers can be counted on the fingers of one hand. Dozens of people are involved in each operation. And after the patient needs to be nursed under the supervision of doctors. What dozens of people know is impossible to keep secret. And all these are fantasies - about black transplant doctors and the fact that someone found some jars where it was written "heart", "liver", "lungs"... Someone had a fantasy. And that's bad. Abroad, from childhood, a child is formed an idea of ​​transplantation as a life-saving science. It is formed by the state, money, efforts and means are invested in it so that people have a correct understanding of transplantation in general.

5. How is the decision on organ harvesting made today?

Brain death is equivalent to biological death of a person. Our life is the life of our brain. After the brain has ceased to live, the heart still beats for some time, because it has its own rhythms.

And if at this time artificial ventilation of the lungs is maintained, 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 are carried out for the presence of viruses, the condition of the internal organs is determined. Several tests are done that confirm brain death. Moreover, brain death is confirmed by a commission that consists of many specialists, and this is done twice over a period of time. And if twice the experts have 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: there was some kind of accident or an aneurysm in his brain burst. Imagine: in the morning, parents and their son drank tea at breakfast, and by lunchtime they are asked permission to harvest organs. Therefore, most often, of course, we get a refusal. Lifetime consent of a person makes the task easier.

This is called the presumption of consent. According to this law, they live in Belarus, Austria, Germany ...

6. How can one agree to become a donor in Ukraine?

Now those who receive passports can enter their consent to posthumous organ transplantation there. But in Ukraine, only 300 thousand of these passports are issued annually. And a critical mass of people who will give their consent to donation in their lifetime will be typed only in 10 years. The law states that consent is entered either in the passport or in the rights. For those who previously received a passport or license, the consent mechanism is not spelled out. I have given public consent in the event of death to organ harvesting to save the lives of others. With the video message that I posted on social networks, I just wanted to say that I trust Ukrainian doctors. That I trust Ukrainian transplantologists. I trust Ukrainian resuscitators who will state the death of the brain.

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

Let me give you an example. When the prime minister of Israel, who was in his 80s, died, he had no healthy organs. But they took the cornea of ​​his eye and transplanted into a girl who had a problem with the cornea.

I know that there is a huge fear of transplantation in Ukraine.

But the realities of life are such that you are 10 times more likely to become a recipient than a donor. Have had the flu. A month later - myocarditis, after three months you are already on the waiting list waiting for a heart transplant ...

This is exactly what happened with an absolutely healthy boy - 13-year-old Bogdan Khorolsky from the Dnepropetrovsk region. He had the flu, and when he went to school, he felt unwell: the flu gave a complication to his heart.

Now Bogdan is fighting for the opportunity to live to the transplant. Doctors have already started his heart several times after stopping. Without a "mechanical heart", a device worth more than UAH 5 million, his chances of surviving before a transplant tend to zero.

Boris Todurov speaks about it. Both the famous cardiac surgeon and the Affects Everyone team appeal to all those who are not indifferent to help Bogdan survive.

DETAILS FOR ASSISTANCE TO BOGDAN KHOROLSKY:

Charitable Foundation "Heart on the Valley"

ЄDRPOU 37432793 AT KB "PRIVATBANK" m. Kiev

MFO to bank: 320649

p / r UA55 320649 00000 26001060714855

Signed for payment: thanks to a donation to the system and mechanical support of the heart of Khorolsky Bogdan

Donations can also be made on the website of the Heart na Dolony charity foundation. To do this, press the button "Grant a donation" and in the line "Appropriate payment" indicate "For Bohdan Khorolsky".