Leap into a new era of medicine

Aleksandr Lukashenko’s decision to develop transplantology has made it accessible to everyone in need, and Belarus has become a world leader in this field

Minsk Research and Practical Centre for Surgery, Transplantology and Haematology                 Aleksandr Kulevsky 

Sincere gratitude

For Natalya Niukalo, a resident of Minsk, the first warning sign was problems with her gallbladder, which eventually had to be removed. Then, progressive ulcerative colitis with total intestinal damage began. Natalya switched to a dietary regime, took 10 tablets a day, but continued to work and care for her family — she led an active life, working as a medic full time and a half, raising twin sons. “I did not despair or complain, I just lived as I knew how and as I could,” said Natalya. “Over time, my condition worsened. The diagnosis was primary sclerosing cholangitis — a rare and severe liver disease, accompanied by inflammation and scarring of the bile ducts. I suffered from constant itching, excruciating and incessant. Bilirubin in the blood was rising, and signs of liver failure began.”
It became clear that a transplant was indispensable. A couple of weeks have passed since the surgery, and Natalya feels better every day, which is confirmed by laboratory data: the level of bilirubin is decreasing, enzymes — markers of liver function — are stabilising. According to ultrasound, the vascular structures — arteries and veins — are functioning perfectly. The woman does not hide her joyful emotions,

“I am sincerely grateful personally to the Head of State, the healthcare system and the staff of the Minsk Research and Practical Centre (MRPC) for Surgery for the fact that such a complex operation as a liver transplant was performed for me free of charge. In other countries, such treatment costs exorbitant sums of money, and Belarus offers real, invaluable help for people. I felt that I was not alone, that I was being taken care of. This gives me the strength to live on and raise my children.”

  

Ivan Shturich and Natalya Niukalo         Aleksandr Kulevsky             Denis Yefimov

Difficult choice

Organ transplantation requires both sustainable funding and serious training of specialists at all levels, with continuous updating of knowledge and skills, as emphasised by Denis Yefimov, a surgeon in the transplantation department, “Next year marks 15 years since I started working at the MRPC for Surgery, Transplantology and Haematology, which I am very proud of. I came here as a student. The President made the decision to develop this sector in a difficult situation, and resources could have been directed to other areas.

Many countries of the former USSR took a different path, considering it more beneficial to send their patients for treatment abroad. Now we support some of these countries in the development of transplantation; their patients are treated in our centre.”

In this field, it is impossible to rest on one’s laurels. Diseases change, requirements increase, and every year doctors must implement innovative solutions. “Thanks to the fact that development continues, so does progress. The success of transplantology rests on the high qualifications of a multidisciplinary team and the need for constant progress, while the backbone is sustainable support at the state level, including the personal involvement of the Belarusian leader,” pointed out Denis Yefimov.

From idea of new centre to modernisation of entire hospital

“At the time of the instruction to create a centre for organ and tissue transplantation, Belarus was only able to perform kidney transplants, but only eight surgeries were carried out in 2005,” shared Professor Oleg Rummo, Director at the MRPC for Surgery, Transplantology and Haematology, Doctor of Medical Sciences, Academician of Belarus’ National Academy of Sciences, Honoured Doctor. “However, a bone marrow transplantation programme had been in place on the basis of the 9th Minsk City Clinical Hospital since 1993, and a strong surgical school specialising in liver and biliary tract operations. It remained to combine these two directions, train specialists and set up a specialised centre based on the 9th hospital. This is what we did.”
Initially, everything was based on initiative and enthusiasm. Projects were implemented through charitable educational foundations, and later, the city health service became involved. A team of Belarusian doctors performed the first liver transplant in the history of Belarus 17 years ago. The surgical intervention lasted 12 hours and was successful — the life of a 31-year-old patient who suffered from end-stage liver cirrhosis was saved. This was a real breakthrough for Belarusian specialists.

On April 10th, 2008, Aleksandr Lukashenko met with the team of doctors and congratulated them on the successful transplantation, “What you have done is a victory for domestic medicine. It is important for us that such surgeries are not isolated cases, but that as many of them are performed as possible.”

The individual rooms in the 9th clinic continued to be re-equipped. The conference hall became a resuscitation department, and the accounting department was transformed into a scientific laboratory and a transplantation unit. The medical institution’s international reputation grew, attracting students from all over the post-Soviet space and patients for surgery from around the world. There was a need for new specialisations, scientific training for postgraduate and doctoral students, and expanded competencies. “The large 9th hospital, serving 500,000 Minsk residents, was nearby; it was impossible to dedicate it entirely to transplantation,” stressed Oleg Rummo. “The idea arose to build a separate centre ‘on a greenfield site’, where only surgeons and transplantologists would work.”
On the instructions of the President, government investments were allocated for the construction of a new building. It cost over $60m! A new building for bone marrow and stem cell transplantation was also built, with some of the funds earned by the clinic and some from the government. As a result, the hospital, which will be 50 years old next year, has been completely modernised and has become a modern Republican Research and Practical Centre for Surgery, Transplantology and Haematology. Comfortable conditions have been created for patients, and the range of services has been expanded. A project for a new admissions department has been prepared — construction will begin next year.

The Minsk Research and Practical Centre will soon acquire the first robotic surgical complex in the country. In the near future, they will begin to perform operations using it — including in transplantology. This is a confident leap into a new era of medicine.

The centre provides transplantological help not only to residents of Belarus, but also to foreigners, who come here from the Balkan countries, Kazakhstan, Russia, Armenia, Israel, Georgia — the geography of requests is expanding every year.
Transplant oncology has become one of the most dynamically developing directions in the MRPC, where they perform over 15 percent of liver transplant surgeries on patients with oncological pathologies.

Heart transplant surgery at Republican Centre for Organ and Tissue Transplantation                      Yury Mozolevsky

NUMBERS

• The Minsk Research and Practical Centre for Surgery employs 2,500+ staff and has over 1,000 beds. 
• This clinic is one of the largest, treating around 30,000 patients annually across various specialities, including emergency cases. 
• The one-year survival rate of patients after transplantation has almost reached 100 percent, and the five-year survival rate is 97–98 percent. These numbers meet global standards and confirm the high level of professionalism of the Belarusian team.

TO THE POINT

The law On Transplantation of Human Organs and Tissues is considered advanced in the field of transplantation by global and European standards.

By Yelena Basikirskaya