Omarova А.К., Turgambayeva А.К., Doskaliyev Zh.А.

JSC «Medical University Astana», Kazakhstan

JSC «National Medical Research Centre», Kazakhstan

RELEVANCE OF CREATION THE NATIONAL COORDINATION CENTRE

FOR TRANSPLANTATION IN KAZAKHSTAN

Today a number of researches are discussing the “global crisis between the number of those who need organ for transplantation and quantity of donor organs” [1], and that “the transplantology has become the hostage of its own success.”

According to the European researchers stabilization between demand for donor organs and their existence has been noted, for example, the indicator is more than 40 kidneys per 1 million of population a year; if the value is below this level, there is a notable demand for donor organs [2]. There are only 10 countries in the world who overcame this recommended threshold, so the five leader countries are Norway (57, 9), the USA (54, 4), Portugal (49, 4), Spain (48, 2), and the Netherlands (46, 5).

Deficiency of donor tissues and organs has led to illegal trade of human organs, especially organs from live donors who do not have related links with recipients. In the last decades there were data on such trade, human traffic, and use of donor organs from state citizens or victims of military conflicts [3, 4].

It is necessary to pay attention to the researchers which have been carried out in the Russian Federation; they are devoted to the organizational aspects of regulation of transplantology [5, 6, 7, 8]. However in the researchers recommendations about improvement of mechanisms of regulation and coordination have not been made. There is still not taken up the question of experiences of researchers in the Islamic countries.

The analysis of references also showed that this problem is almost unexplored in Kazakhstan. It is possible to identify two research projects affecting the organization and regulation of Trasplantology – Berik K.B. (1990) [9], in which for the first time in our country were studies the civil and legal problems of transplantation of human organs and tissues, and Ospanova A.K. (2010) [10], in which was studied the level of awareness and willingness of population to donor organs as on example of the city of Astana. The solutions of strategic challenges, which the Health Care System of the Republic of Kazakhstan has faced, has already led to the increase in the number of operations of transplants, and expose the problem of shortage of donor material. However an adequate solution of this problem is impossible without a deep study of the legal regulation of taking-out of tissues and organs.

In this regard it is necessary to develop appropriate mechanisms for coordination and management of these processes in Kazakhstan.

The tree-level model of structure of the National Coordination centre for Transplantations is offered (Figure)

Figure-model of the structure of the National

Coordinating Centre for Transplantology in Kazakhstan

The purpose of this model is to provide coordination support for the establishment and development of transplant services in the Republic of Kazakhstan.

Therefore, it is necessary to prepare the proper organization and development of transplant services in Kazakhstan, everything in accordance to the international norms and standards:

• creation the effective national system of donation, functionally linking hospitals providing emergency medical care, and providing timely transplantation of donor material on the basis of stationary coordination and public funding; promotion the development of science in the field of transplantation, and implementation of its development;

• carrying out educational programs to prepare highly qualified specialists of the service of transplantology;

• ensuring optimal interaction between the available clinics carrying out organ transplantation;

• strengthening of work aimed to attract international best practices with the maximum use of the foreign scientific community;

• interaction with the interested government bodies and departments;

• close work with health care organizations, carrying out such activities as HLA-typing, cross-match reactions of donor tissues and (or) organs (part of organ) and recipients, as well as with laboratories of infection control;

• development of the algorithms of taking-out, preservation, transplantation of organs (part of organs), tissues and cells;

• within the Republic providing 24-hour transplantation of organs (part of organs), tissues, cells and biological materials from donors for transplantation to recipients;

• interaction with the interested government bodies and departments. Participation in the development of legal documents regulating the activities of transplantation service;

• participation in creation of the Unified National Registry of donors and recipients; the implementation of the selection pair “donor organ - recipient” with regard of the date if inclusion in the waiting list;

• development and implementation of the mechanism for accounting persons who have expressed a lifetime consent to take-out tissues and (or) organs (part of organs), and cells after death;

• formation of surgery teams, coordinating the actions of the teams of the other hospitals;

• interaction with mass-media and-non-governmental organizations concerning donorship promotion among the population.

Thus the national Coordinating Centre for Transplantation (hereinafter – the Centre) coordinates the various activities within the work of the Centre to discuss scientific and organizational issues corresponding to the Centre objectives, and participates in the preparation and holding of events organized by government or other public associations.

References

1 Nicholson M. Kidney Transplantation from Non-heartbeating Donors. Peterborough: The national Kidney research Fund. - 2002. – 189 p.

2 Delmonico F., Domhnguez- Gil B., Matesanz R. A call for government accountability to achieve national self – sufficiency in organ donation and transplantation // the lancet .-2011.-Vol. - 378.- N.15. - P. 1414 - 1418.

3 Jiefu Huang, Millis M., Yilei Mao et al. A pilot programme of organ donation after cardiac death in China \\ the Lancet. 2011. - Vol. 376. - P. 6736 - 6738.

4 Prisoners as organ donors: is it worth the effort? Is it ethical? // Transplant. Proc. - 2009. - Vol. - 41. - P. 23-44.

5 Alexeyeva P.L. Legal problems of clinical transplantation of organs and tissues in Russia and abroad: Administrative and Legal Aspects. Abstract of PhD Dissertation. Moscow. 2005. – P. 35.

6 Rubanova N.A. A human right on life in the legislation of the Russian Federation: concept, contest, legal regulation. Abstract of PhD Dissertation. Rostov-on-Don. 2006. – P. 33.

7 Margatskaya N.A. Civil problems of donorship and transplantation. Abstract of PhD Dissertation. Moscow. 2005. – P. 29.

8 Mussiyenko A.V. The prevention of crimes in the field of transplantation of human organs and tissues. Abstract of PhD Dissertation. Kiev. - 2010. – P. 33.

9 Berik K.B. Nationality – legal problems of transplantation of person`s organs and tissues. Abstract of PhD Dissertation, the Candidate of Legal Science. Almaty. – 1999. – P. 33.

10 Ospanova A.K. Development and implementation of social marketing of organ and tissue donation. (JSC “National Science Centre of Emergency Medical Service”. Abstract of PhD Dissertation of the Master of Business Administration. Astana. 2011. – P. 29.