ByadminTransplantation in Poland: annually about 500 organ transplantation operations
Disputes about the basic principles of transplantation do not subside in the countries of the post-Soviet space: which is more correct – tacit consent or tacit objection? While statesmen are debating this topic, patients are dying without awaiting for a vital organ transplant operation. This problem is especially relevant in Ukraine, where posthumous transplantation was illegal until recently.
Transplantation has been developing successfully for a long time In Poland. Even the Catholic Church supports the development of this segment of medicine, realizing the benefits and possibilities of transplantation. Back in the late 90s of the last century, a corresponding database appeared in Poland. Legislation in this area is constantly evolving to meet the needs of the time.
History
Clinical transplantation began in Poland in the 1960s. In January 1966, the first kidney transplant from a deceased donor took place in Warsaw, and less than 2 months later the first living donor kidney transplant was performed in Wroclaw. However, a breakthrough in Polish transplantation came in 1983, when an immunosuppressive drug was first used to prevent transplant rejection.
The team of Professor Zbigniew Relig performed the first successful heart transplant in Zabrze in 1985; the first upper limb transplant was performed in Trzebnica in 2006; a face transplant took place in Gliwice in 2013; the first complex transplantation of neck organs (larynx, trachea, pharynx, oesophagus, thyroid gland) was performed also in Gliwice in 2015. The first lung and liver transplant took place in Zabrze in 2019.
Legal aspects
The Transplant Law (as amended in 2009 and 2017) is in force In Poland currently, which defines who and under which circumstances can become a donor, who has the right to collect and implant organs. Since 1996, Polish transplantology has been supervised by the Organizing and Coordinating Center for transplantation Poltransplant. The centre maintains the Bone Marrow Donor Registry, the Central Objection Registry and the National Patient Awaiting Transplant Registry.
The Polish Transplant Law provides for the principle of acquiescence. In other words, the receipt of cells, tissues and organs from a deceased person is possible if the deceased did not object, that is, his name is not entered in the Central Register of Objections, or if he has not expressed objections orally to at least two persons who can confirm this in writing.
In case if a decision is made to rake organs from the deceased, his family is notified of this, but only in order to clarify whether the deceased is included in the Central register of Objections. If not, then the family in this case does not have the right to decide for the person after his death.
What is an organ donor?
An organ donor is a deceased person having at least one organ taken for transplantation. More than half of actual donors have at least two different organs taken. There were 1,962 patients in the National Register of People Awaiting Organ Transplantation in September 2019, according to information from the Poltransplant database. There were 639 actual donors in 2019, and there were 502 real donors, that is, whose organs were transplanted.
The development of transplantation has made the concept of death more precise. Currently, the term “brain death” is used for transplantation purposes. The diagnosis of brain death is based on the detection of irreversible loss of brain function. The criteria and method for determining permanent irreversible cessation of brain activity are defined in a special order of the Minister of Health.
An amendment to the Transplant Law introduced the ability to harvest cells, tissues and organs after a diagnosis of irreversible cardiac arrest. The criteria for determining irreversible cardiac arrest prior to collection of cells, tissues or organs for transplantation are also defined in a special order of the Minister of Health.
Transplantation and the Catholic Church
The Catholic Church is sympathetic to the problem of transplantation. Pope John Paul II has repeatedly spoken out in support of the development of transplantation: “Transplantation is a big step forward in the service of human science, and many people today owe their lives to organ transplantation. One of the ways to cultivate a true culture is organ donation to ensure health and even life for the sick, who sometimes have no other hope”.
