Is it possible to transplant a kidney in the basement: 10 myths about organ transplants and their refutation

2024 Author: Malcolm Clapton | [email protected]. Last modified: 2023-12-17 03:44

Is there a black market for organs and is there a chance that a person in intensive care will not be rescued in order to get their heart or lungs? Let's take a closer look at the main misconceptions about organ donation and dispel them.

1. You can remove and transplant organs to everyone

Organ donation is an extreme case when other measures are no longer able to help, since not every disease can be cured. At the same time, often the cause of a serious state of health is not at all a disdainful attitude towards one's own health.

Among those in need of transplantation are children who were born with any serious illness that puts their lives at risk from day to day. Therefore, organ transplantation is often their only chance of salvation.

Every day, about 22 people, that is, about 8,000 a year, die by the Organ Procurement and Transplantation Network, waiting in line for the organ needed for transplantation.

An important condition for transplantation is the selection of a donor-recipient pair, which is carried out on the basis of individual laboratory compatibility.

In Russia, in the event of a person's death, there are a number of reasons why donation is impossible. For example, in the clinical guidelines Posthumous organ donation "Posthumous organ donation" includes: acute viral encephalitis, some types of primary malignant brain tumors. In addition, potential donors are carefully checked for the presence of serious diseases - HIV, viral hepatitis B and C, syphilis. Donation is excluded if at least one of the diseases is confirmed.

2. Almost all organs can be transplanted

Organs that can be transplanted include: heart, kidneys, lungs, liver, bone marrow and others. This list is the Order of the Ministry of Health of the Russian Federation, the Russian Academy of Sciences of June 4, 2015 N 306n / 3 "On approval of the list of transplantation objects" approved by the Ministry of Health of Russia together with the Russian Academy of Sciences. This does not include organs, their parts and tissues that are related to human reproduction (eggs, sperm, ovaries or embryos), blood and its components.

Today there are two types of organ donation: intravital (related) and posthumous.

In the case of an intravital donation, it is possible to transplant a kidney, part of the liver or a fragment of the small intestine. After death, cases of transplantation of not only one, but also 3–6 organs at the same time are possible.

Italian neurosurgeon Sergio Canavero suggested Surgeon Sergio Canavero: I will open the way to immortality by transplanting the body to the head of a living person. This idea caused a resonance all over the world, since in this case a person will most likely be able to live, but will not be able to move and breathe normally. Such a transplant has not yet been performed.

3. People are killed to sell organs

No, it’s not like that. This is simply pointless for a number of technical reasons. One of them is that a deceased person must be connected to artificial life support systems. Otherwise, his organs will not be suitable for transplantation.

Artificial ventilation of the lungs provides oxygen to the lungs, the artificial circulatory system delivers oxygen to all organs of the deceased donor, ensuring their normal functioning. This process is called organ donor conditioning. This part of the work is the area of responsibility of resuscitators. Therefore, it is extremely difficult to carry out the safety of organs without specialists of the appropriate profile and the necessary equipment.

In addition, not all medical organizations carry out organ transplants. Currently, donor organs are transplanted in 52 clinics and medical centers in Russia. At the same time, far from each of them, different organs are transplanted in equal proportions; most medical institutions specialize in kidney transplantation.

4. Bodies sell overseas

Not at all. International acts prohibit the sale of donor organs. Transplant tourism (travel to another country for the purpose of organ transplantation) is also condemned by the international community. Thus, the Istanbul Declaration on Transplant Tourism and Organ Trade (adopted in 2007, updated in July 2018 in connection with clinical, legal and social changes in the field of transplantation) states the Istanbul Declaration on Transplant Tourism and Organ Trade: “Trafficking in human organs and trafficking in persons for the removal of organs from them should be prohibited and considered a criminal act”.

Organs cannot be lost. Firstly, in Russia, transplantation is possible only for citizens of our country. Secondly, it is impossible to know for sure which hospital a donor with suitable organs is in, since the time of the operation, information about donors, recipients, as well as indications and results of transplantation are recorded in the information system of the Ministry of Health of Russia and are not available to a wide range of people.

Moreover, it is not possible to illegally transport organs by plane, and even more so by any other vehicle. For transportation, appropriate documentation and technical equipment is required. Who dares to take such a step?

5. There are clandestine clinics where organ transplants are performed

Since organ transplantation is a high-tech complex operation, transplantation can only be carried out in a staffed clinic. A medical facility should have: an intensive care unit equipped with a life support system, a team of transplant surgeons, junior medical personnel, a laboratory that allows performing expensive and complex tests, an artificial kidney apparatus, and much more.

It turns out that the clandestine clinic should be "to the teeth" equipped with both expensive equipment and highly qualified personnel.

It is impossible to organize a medical facility of this level in a basement, as well as to create a team of professional experienced doctors who are ready to commit a crime.

6. "Operated and forgot" or "They live with a transplanted organ a little, and all are disabled"

If the patient after the operation neglects to take special medications - immunosuppressants - rejection of the transplanted organ may occur.

It is for this reason that after transplantation, the patient must be routinely observed by a doctor, undergo tests and monitor the performance of the transplanted organ. Subject to the recommendations, organ donor recipients lead a full life: they study, work, create families, give birth to children, and play sports.

7. Transplantation is a business

In Russia, this type of high-tech medical care is received by the Federal Law of November 21, 2011 N 323-FZ "On the Fundamentals of Health Protection of Citizens in the Russian Federation" funding only from the state budget. Therefore, organ transplant is not a business. None of the citizens of the Russian Federation pay for organ transplant services. In addition, in Russia, the so-called emotional donation is not legalized - intravital donation from a person who is not a blood relative.

According to the chief transplantologist of the Russian Ministry of Health, director of the N. N. IN AND. Shumakov, Academician of the Russian Academy of Sciences Sergei Gauthier, emotional donation everywhere runs the risk of becoming paid, which is contrary to the principles of the World Health Organization.

The restrictions established by the legislation of the Russian Federation are aimed at prohibiting the Law of the Russian Federation of December 22, 1992 N 4180-I "On transplantation of human organs and (or) tissues" of the commercialization of the field of organ transplantation. Organ transplantation is carried out exclusively within the walls of state medical institutions that have the necessary license and are listed in a special list approved by the Ministry of Health of Russia and the Russian Academy of Sciences.

As we wrote above, donors, like recipients, are entered into the system of the Ministry of Health of the Russian Federation. Given this fact, transplantation is technically impossible to commercialize. Also, the medical institution must notify the prosecutor in writing about the removal of organs from a posthumous donor for the purpose of transplantation.

Moreover, Russian law criminalizes coercion into organ donation and organ trafficking.

The existing proposals on the Internet about trade in organs are the basis for checking by law enforcement agencies, and in themselves, in all cases, are a "scam for money."

8. Those who are in intensive care are not rescued in order to take their organs

In fact, transplant doctors do not have the right to take part in the provision of medical care to a person who is in intensive care. This special rule is enshrined in legislation and implemented in practice in Russia.

Absolutely all diagnostic and treatment activities are carried out according to approved standards, instructions and clinical guidelines.

So, when a person's brain dies, a death statement is established, regulated by the document Order of the Ministry of Health of the Russian Federation of December 25, 2014 N 908n On the procedure for establishing the diagnosis of human brain death”of the Ministry of Health of Russia. It includes a number of studies and various tests. The duration of the ascertaining death is 6–12 hours, sometimes it takes longer. The death of the brain is established by a council of doctors, which includes the attending physician, anesthesiologist, and neurologist with at least five years of work experience.

In Russia, as in many developed countries, the Federal Law of 21.11.2011 N 323-FZ (as amended of 03.08.2018) "On the basics of protecting the health of citizens in the Russian Federation" is in force. Presumption of consent. This means that every person after death can become a donor. If the deceased during his lifetime expressed disagreement with posthumous donation, then organ removal is not carried out.

If the patient nevertheless dies and, according to known criteria, can be an organ donor (while there is no information about lifetime disagreement with donation), then with the permission of the chief physician, a team of doctors is invited to perform donation work. Their task is to preserve donor organs in the body of a deceased person, perform an operation and ensure the safety of organs during transportation to the place of transplantation. One case of donation can save the lives of five patients.

9. Orphanages - a win-win option for organ donation for "black" transplantologists

According to the law, the Law of the Russian Federation of December 22, 1992 N 4180-I "On transplantation of organs and (or) human tissues", the removal of organs from persons under 18 years of age is prohibited. In the event of death, children can be considered as donors only with the informed consent of the parents. Orphans cannot be donors Federal Law of 21.11.2011 N 323-FZ (as amended on 03.08.2018) "On the basics of protecting the health of citizens in the Russian Federation", in this case even the consent of the guardian will not work. In these matters, the legislation of the Russian Federation "from" and "to" intersects with world practice and the recommendations of the World Health Organization.

10. When establishing the death of the brain, sometimes they make mistakes

This diagnosis means that the human brain is damaged so much that the work of the heart and respiration are produced only by drugs, that is, artificially. Even if the organs are not planned to be used for transplantation, brain death is still stated by the Order of the Ministry of Health of the Russian Federation of December 25, 2014 N 908n On the procedure for establishing the diagnosis of human brain death. In Russia, brain damage or death of its cortex does not become the basis for organ transplantation.

Since the 1980s, not a single mistake has been recorded in the diagnosis of brain death on the territory of the Russian Federation.