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Transplantation

1970 can be called the formation year of the Belarusian organ transplantation. It was the year when Academy Fellow N.E. Savchenko performed the first kidney transplantation surgery at the Fourth Hospital of Minsk, specifically, at the Urology Clinic of Minsk State Medical Institute. However, only 0.8 transplantations had been performed per 1 million people in Belarus by 2005.

The situation changed drastically in 2008 when a decision on the necessity to develop organ transplantation in the country was taken at the highest state level. As a result, a program for liver, kidney and heart transplantations was developed and the Republican Organ and Tissue Transplantation Centre was opened in March 2010. 

The Republican Organ and Tissue Transplantation Centre

In the course of preparation to the Centre’s opening, Belarusian transplant surgeons undertook internships at the best university clinics of the EU and USA – in Birmingham, Oxford and Hannover. Meanwhile, the most advanced therapeutic and diagnostic equipment was being installed at the Republican Organ and Tissue Transplantation Centre.

Three resuscitation departments and intensive therapy departments are equipped with most advanced artificial liver-kidney apparatus as well as monitoring and life-support equipment. All operating rooms of the Organ and Tissue Transplantation Centre are internationally certified. Along with the opportunity to hold online video conferences with the leading clinics of Europe, Asia and America, there is an opportunity to broadcast operations online to classrooms with the purpose of teaching students.

Concentration of transplant surgeries in one centre, best medical equipment and the latest technology have given Belarusian doctors a chance to reach the minimal hospital mortality rate (the number of patients who die at hospital). In Germany, for instance, this rate varies from 5.5 to 14.5 per cent for liver transplantations depending on the centre. In Belarus it equals to 4 per cent.

Such an approach allowed Belarus to reach the first place in terms of the number of organ transplant surgeries among CIS countries in 2011. Currently, the country firmly holds its leading position. In 2013, 29 surgeries of the kind have already been performed per 1 million people. Specialists predict that this number will reach 35 in 2014.

In as few as 5 years – from early 2008 until 2013 – the number of organ transplant surgeries in the Republic of Belarus increased 35 times. The transplantation program was initiated, first of all, to satisfy the needs of the country’s citizens. This is why all transplant surgeries are free for Belarusians. 

Following the example of many European countries (Austria, Sweden, Belgium, the Netherlands, Hungary), the Belarusian legislation in the sphere of organ transplantation provides for presumed consent. There is a Unified Transplantation Register in the country containing data on the patients who have already had a surgery as well as the data on the citizens who do not consent to using their organs as donor ones. 

The process of donor organ recovery is extremely transparent. The General Prosecutor’s Office is notified of compliance with all legal procedures, and only after that an organ can be recovered.

Mastering new transplant technologies has become one of the key activities of the Organ and Tissue Transplantation Centre. This is why, besides kidney, liver, heart, pancreas, cord and placental blood cells and bone marrow transplant surgeries that have already become “traditional”, the Centre’s specialists can also perform complex organ transplant surgeries. Surgeries of such level of complexity are very rare in the world. 

In 2009, the pancreas-kidney complex transplant surgery (one of the rarest surgeries in the world) was performed in Belarus, in January 2012 the liver-kidney complex was transplanted, and in February of the same year the surgeons (2 teams participating) were successful at transplanting a heart and a kidney to a patient.

Belarusian specialists are planning to perform equally challenging surgeries – a heart-and-liver as well as a heart-and-lung one. The first lung transplant surgery is planned for the second half of 2013.

Admittedly, in February 2013, transplant surgeons have already managed to transplant a heart to a 11-year-old child and perform a unique sublobar lung autotransplantation surgery. Before that, such a surgery had been performed only once by Japanese surgeons. During the surgery, a 58-year-old patient’s lung was recovered, cleaned and implanted back.

In Belarus, not only the Republican Organ and Tissue Transplantation Centre is involved in organ transplantation, but also regional centers located in Brest, Gomel and Grodno. In 2011, the first regional kidney transplant surgery was performed in Brest, and by the beginning of 2013 the number of such surgeries reached 50 there. In the first quarter of 2013, the first such surgery was successfully performed in Grodno as well. The transplantation centre in Grodno commenced its activity in 2012. 

Today, Belarusian specialists provide active assistance in developing organ transplantation practices in the neighboring countries. Numerous workshops are held abroad. Transplant surgeons from Russia, Kazakhstan and the Ukraine undertake their internships in Belarus. Before the first liver transplant surgery, Kazakh surgeons took a long internship at the Republican Organ and Tissue Transplantation Centre in Minsk.

 

The material has been prepared with the support of JSC “MTBank”