Usual medicines are no longer a panacea


Transplant technology is advancing significantly in Belarus — as confirmed by recent groundbreaking heart transplant operations. By late 2009, a Transplantology Centre is to open in Belarus, created on the basis of two blocks of the 9th clinical hospital (now being reconstructed). A national bank of donor tissue and organs is also planned.

The most valuable bank. “Transplants offer the only chance of survival to those beyond the reach of standard medical treatment,” notes the Chief Transplantology Specialist at Belarus’ Health Ministry, Doctor of Medical Sciences Anatoly Uss. “In addition to organ and cell transplants, tissue transplants have proven successful in recent years. These include the use of heart valves, blood vessels, eye corneas and bone marrow. Such operations are already being conducted — though in limited number. This branch requires a serious approach, so a national bank of donor tissue and organs is being set up.”

Tissues for transplantation currently originate from the forensic bureau but Mr. Uss believes the structure’s subordination to the Prosecutor’s Office is inappropriate. In the near future, a small donor tissue bank is to be established at the 9th clinical hospital, occupying a specialised laboratory dealing with cell technologies. Meanwhile, a fully-fledged bank of donor tissue and organs is to open some time later, meeting Health Ministry requirements. Two additional blocks are being built at the hospital — currently under design — with the launch date dependent on design, construction processes, equipment delivery and personnel training. All transplantation technologies applied in the country are to be located at this Minsk clinic. “The donor bank will help us develop transplant technologies. In addition to our existing experience of kidney, liver, heart and pancreas transplants, we’ll be able to transplant tissue,” explains Mr. Uss.

Treatment, transplantation or cultivation… Experts from the World Health Organisation say that the age of chemical medicine is over. Medicines are no longer a panacea, since more effective and alternative methods of treatment are appearing — including transplantology. “Burns are a very serious problem in medicine,” Mr. Uss notes. “Prospects are never rosy when there are extensive burns; however, tissue transplants can replace dead skin. The difficulty is that donor skin is easily rejected; a tissue bank is vital in allowing us to find a good match. In fact, organ transplantation should eventually be replaced by the use of tissue grown from patients themselves. This would be much cheaper and would avoid rejection and other complications for the patient.”

Experiments in the field are already being applied in clinics worldwide; Mr. Uss stresses that Belarus is keen to look to the future, learning from foreign colleagues via internships at leading medical centres abroad.

I’d become a donor… Almost anyone can donate stem cells. All that is needed is a medical examination and blood test. Data is then entered and, if a match is found, donors undergo a painless (though several hour-long) operation to remove cells. Bone marrow donorship is far more serious of course, and only involves close relatives. The Minsk city register of stem cells and bone marrow already holds information on over 1,000 donors but up to seven times more are needed to ensure the system works efficiently. Doctors are already setting a good example; all Transplantology and Cell Biotechnology Centre staff are listed as donors of stem cells.

Donorship of organs is yet more complicated. Most donations are made following death, although a kidney or part of a liver may be donated while the subject is living. Naturally, it is a very delicate medical issue — involving moral and ethical principles. Belarusian transplantology legislation presumes consent unless a written abdication is made to the Health Ministry (or to the district hospital for forwarding). Russia and many European states also apply this scheme, although relatives can step in to prohibit the taking of organs from a dead person. Most often, people treat the problem with understanding, since the life of one person can save three or more other people.

[i]By Valeria Gavrilova[/i]
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