Rescue technology

In Belarus, 1,170 liver transplants have been performed since 2008, including transplants for cancer patients

It has been 17 years since a team of doctors from the 9th Minsk City Clinical Hospital — now the Minsk Scientific and Practical Centre for Surgery, Transplantology and Haematology — led by Oleg Rummo (then Deputy Chief Physician for Surgery) performed the first liver transplant in Belarus. The unique surgery lasted 12 hours. As a result, the life of a 31-year-old patient suffering from the end-stage liver cirrhosis was saved. This was a real breakthrough for the team of Belarusian doctors, and first and foremost for Oleg Rummo, who was the first to master the highest level of surgery during his internships abroad.  On April 10th, 2008, President of Belarus Aleksandr Lukashenko met with the team of doctors and congratulated them on the successful transplant, “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.”

How the clinic became space 

Since the very first transplant, which took place on the night of April 2nd—3rd, 2008, the clinic has lived a long and dignified life. From a six-bed intensive care unit and one operating theatre, which now houses a conference hall, the centre’s staff and its director — Doctor of Medical Sciences, Professor, Academician of the National Academy of Sciences, Honoured Doctor Oleg Rummo — have come to what is now called the Minsk Scientific and Practical Centre for Surgery, Transplantology and Haematology. “This is 2,500 employees and more than 1,000 beds,” Oleg Rummo clarified. “The centre unites the 9th clinical hospital and services created over 17 years, new buildings in the form of a surgery and transplantology building, a haematology and stem cell transplant building, a huge scientific department that carries out the most relevant research in modern medicine. All this has happened in 17 years, but the most important thing is that over these years, a huge number of our patients have received a chance for a normal, full life.”
There have been performed 1,170 liver transplants and over 5,000 kidney transplants, systems for providing transplant care to the population of our country have been created, kidney transplant departments have been opened in all regional centres, dozens of specialists have been trained in Belarus and abroad, hundreds of patients from different countries have been treated, colossal international authority has been gained, and young specialists are being trained. 
Children are a special emotional component for the centre’s team. It all began in 2009, when a liver was transplanted here to a 16-year-old boy who was poisoned by a death cap. Now this young man works as a coach in Gomel. The next serious patient was a two-year-old child who received a liver from a living related donor — his father. This is how the Minsk Scientific and Practical Centre for Surgery began to save children. Every year, liver transplants are performed on 6-12 small patients.

State-of-the-art technology 

The 30-bed transplant department is located in the new building of the Minsk Scientific and Practical Centre for Surgery, Transplantology and Haematology. “Our department provides medical services both for Belarusians and for export,” emphasised Ivan Shturich, the head of the department. “We perform over 90 liver transplants and 170-180 kidney transplants per year. We perform retransplantation and simultaneous operations — ‘liver — kidney’, ‘pancreas — kidney’. We treat many patients from Kazakhstan, Armenia, Israel, Serbia, Montenegro, Bosnia and Herzegovina. We have earned authority: patients see the quality and want to come to us.”
Both the number of liver transplant surgeries and the complexity of the diagnoses, for which these interventions are performed, are growing in the centre. Ten years ago, such difficult cases were not even taken on. For example, the liver of Anastasia Fenko from Minsk weighed 26kg when it was removed. The patient had a metastatic neuroendocrine tumour. To save and improve her quality of life, she received a liver transplant. 
The personnel of the Minsk Scientific and Practical Centre have implemented many technologies for immunosuppressive therapy in the post-surgery period. In particular, they use mesenchymal stem cells, which allow minimising the intake of the main immunosuppressants. The specialists also perform split-liver transplantations, when one liver is divided and the two parts are subsequently transplanted in two recipients. Using this method, six years ago, doctors saved a mother and a child who were poisoned by a death cap. 
The most important thing in the development of technologies is certainly human potential, but equipment also plays a significant role. Thus, microscopic systems allow obtaining multiple zooming of vascular and, in particular, arterial connections with the ability to display and broadcast. Ultrasound-based devices are becoming good assistants. The Minsk Scientific and Practical Centre boasts equipment for any occasion! 

State care and innovations in treatment 

Approaches to liver transplantation are developing in the world in a number of areas. Belarus is no exception. First of all, this is transplant oncology — the number of such patients is increasing from year to year. 
“New technologies are developing here, new hospitals are being built, the equipment park is high-class,” underscored Oleg Rummo. “All this is happening thanks to the unprecedented support of the state. Belarusians receive free help, although it comes to a huge sum for the state budget. Imagine: a liver transplant surgery costs more than one hundred thousand dollars. This is exactly the amount paid by foreigners who come to us for treatment.” 
The surgery and transplantation building was built on the basis of the Minsk Scientific and Practical Centre using state money. It cost more than $60m. The state also lent a shoulder in the construction of the haematology and bone marrow transplant building. A lot of money is invested in the acquisition of modern equipment.
“A year and a half ago, we bought a state-of-the-art linear accelerator, which costs €3.5m,” recounted Oleg Rummo. “True, we, for our part, invested the money we earned in preparing the premises and training the personnel, but the main funding is from the state budget. As a leading specialist in surgery and transplantology, I have travelled all over the country and I see what equipment our district hospitals, inter-district centres, and regional clinics are fitted with.

Previously, we could only dream of this! A lot of facilities are being built, too — for example, a surgical building at the regional hospital in Borovlyany, surgical buildings in Vitebsk and Brest, a new hospital in Grodno. Recently, buildings for regional hospitals have been opened in Mogilev and Gomel. These are huge state injections.” 

TO THE POINT 

The Belarusian Law On Transplantation of Human Organs and Tissues is, by global and European standards, the most advanced legislation in the field of transplantation.

By Yelena Basikirskaya

Photos by Aleksandr Kulevsky