In 2017, Republic of Moldova lost eight organ donors who could have saved lives, because of bureaucracy and interests
Our medical system lost another potential organ donor last week. It is the eighth during this year that could save other lives. It happened due to the fact that the waiting lists are too short and there weren’t compatible recipients with AB blood type. Waiting lists, especially kidney transplant waiting list, are still shorter than they should be. The officials say that eight potential life-saving donors worth so much for any other country, especially for Moldova.
22 ianuarie, 2018, 10:02
If you still believe that the majority of people in Moldova refuse to donate their organs because they find this subject to controversial, you are wrong. Moldovans have learned to give life to others through organ donation and they do it more often than we have been accustomed to believe. Another problem seems to be crucial for the transplant system in Moldova – the transplant waiting lists do not correspond to the real needs. This is how eight people could become rescuers of many lives after death with the consent of their relatives. In some cases, doctors harvested less organs than possible. In some cases, only the liver, without kidneys, was taken, because compatible recipients were not identified in time. In other cases, the transplant teams were abroad, and all the efforts of diagnosis, maintenance, coordination were ruined, because there were not specialists.
When in eight out of twenty organ donors the available organs were not fully used due to the lack of compatible recipients or due to management and logistics factors, it is quite alarming. It is a big number for Moldova. “For example: the situation is better in Moldova than in Britain when we talk about the agreement of relatives" says Igor Codreanu, director of the Transplant Agency. According to the specialists, one person can donate after death in Moldova: the kidneys, the liver, the corneas, bones, magisterial vessels and skin.
The head of the Transplant Agency says that the waiting lists are still lower than the international statistics show. In particular, we are talking about the kidney transplant waiting list. "Now there are 84 patients on liver transplant waiting list, and only 35 on kidney transplant waiting list, but the figures should be reversed. We have talked a lot about this topic with the representatives of the Ministry of Health, we had meetings, the situation slightly improved, but the number is still very small, "adds Dr. Codreanu.
In addition to the problems related to the inclusion of patients in the dialysis patients register; there are also resources management issues. "There were cases when the transplantation team was not in the country and potential donors were lost. At the beginning, a single team was trained for liver transplantation and even now it is sufficient, but if they are missing, everything stops”
Organs exchange could save lives
In order to unlock the situation, the Transplant Agency started negotiations with Romanian authorities to start the exchange of organs between Romania and the Republic of Moldova. If such an agreement had already existed, the organs lost here could have saved lives in Romania. And vice versa - patients in Moldova could have had more saving chances thanks to donors from Romania
„We know that the demand for transplantation is higher than we can do it now. However, it is important to stop the loss of potential donors. This agreement would allow us to save our patients who need heart or lung transplant, which are not performed in our country. At this moment, we have a complaint from a patient who is in need for a cardio-pulmonary transplant and we couldn’t do anything right now. It is a solution applied in many countries. In Slovenia they don’t perform lung transplant, but they have an agreement with a Transplant Centre from, Austria. Romania does exactly the same, " Dr. Codreanu says.
Also, in the Twinning Project evaluation report, a programme implemented by the Transplant Agency a few years ago, experts identified a breach in organs using capacity from potential donor in our country, and the optimal solution would be the signing of international agreements. "In 2016 we had 15 deceased donors, which meant 30 potential kidneys, but only 14 were transplanted because there were not enough recipients on the waiting list and we haven’t the possibility to send organs abroad, due to the lack of international agreements. In Moldova there is a relatively high number of unused organs. In this context, the legal framework needs to be improved in order to allow the organs exchange with the EU, "the report said.
Thus, the possibility of organs exchange could allow our patients with serious condition to benefit from a priority transplant in another country. The negotiations will start this month.
Public-private partnership with debts
After a period when we noticed that the transplant waiting list is too "subtle" a commission assigned by the Ministry of Health visited to dialysis centres to check the information about patients, in order to understand what is happening. Medical data confirmed that many patients eligible for kidney transplantation were not included in the dialysis register, and subsequently, were not included on the waiting list. There were many explanations, but without doubts, there were a deviation, that’s why 63 patients were not included on the list, this way losing a chance for a better life. The majority of patients (30) potentially eligible for transplantation are treated at BB-Dialysis. For one dialysis patient, the state spends about 263 thousand lei for one year, while the costs for transplantation are about 90 thousand. If they are not transplanted, these patients are more predisposed to complications and death. The authorities signed a PPP with the German consortium BB-Hämodialyse Handelsgesellschaft, the winner of the tender for the development of haemodialysis services in Moldova, but the conditions are not fully respected by the private partner. Prior to signing the contract, the authorities increased the cost for a dialysis session, and that came like a glove for private partners. In the link below you can find this article in romanian language:
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