There is no crime, smuggling, selling, or anything illegal and concealed in transplantation.

“By donating organs of a deceased member, a family can save as many as five or six lives. Before brain death occurs, medical doctors take all the measures in an attempt to treat the patient,” Dr Goran Rondović, Assistant Professor and Lieutenant Colonel, anaesthesiologist and Director of the Cardiothoracic and Vascular Anaesthesia and Organ Donation Coordinator at the Military Medical Academy (MMA), one of the people who steps in when a patient’s brain death has been confirmed, making him a potential organ donor, said in his interview with Kurir.

Over 2,000 people in Serbia are waiting for an organ as their only cure and a chance to live, but families say “no” far more often than “yes” when asked by doctors to donate the organs of a person close to them who is braindead.

Firstly, many people do not realize that brain death means there is no return and that the heart will soon stop beating. And it is precisely these precious hours between brain death being declared and the heart stopping beating that can save lives.

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Zorana Jevtić 

A dead brain

“When a patient is in a difficult condition and their life is in danger, all intensive therapy methods are applied for the purposes of treatment. However, if they fail or additional complications arise, and there is suspicion of brain death, diagnostic procedures are initiated to confirm it. They are a series of tests, which include examinations by a neurologist, a neurosurgeon, and an anaesthesiologist, as well as a Colour Doppler test to measure blood flow through the brain, and potentially a CT angiography scan to view blood flow through the brain. When all these procedures are combined and they show there is no blood flow or life in that brain, the legal requirement has been met to declare that the person’s brain is dead, i.e. that brain death has occurred, and therefore the death of the organism,” Dr Rondović explained, adding:

“The fact that the heart is still beating and that the patient is on life support, still breathing by means of a machine, does not mean he or she is alive. They are legally dead once brain death occurs, and death is therefore declared. We can keep the body and organs for some time, which isn’t long, and it depends on the patient’s conditions – between two to three hours up to around 24 hours.”

OLD AGE AND ILLNESS

‘Not everyone can be a donor’

In order for someone to become an organ donor, in addition to brain death, there are certain conditions that he or she must meet that have to do with age, as well as the illnesses that they have been treated for.

“Patients getting treatment for malignant conditions cannot donate organs. The age limit moves depending on the organ to be transplanted. The upper limit for a liver transplant is 65, and it is 70 for kidneys,” Dr Rondović noted.

The family is kept informed about the patient’s condition, including brain death.

Misconceptions

“When we conclude that a patient can be an organ donor, we present this information to the family. But sadly, many more families refuse to donate organs than accept. The most frequent answer is that they are not sure if the deceased would want that too, as well as that they have religious reasons against it, or that they don’t wish to have their close one additionally cut up or whatever. There are those who don’t know how to respond because they haven’t heard of transplantation before,” Dr Rondović said.

And this is why, according to the doctor, we must work on promoting organ donation.

“We must work on explaining to the general public that there is no crime here. People suspect that someone will sell their relative’s or close one’s organs, and that these organs will go God knows where. Let me stress here – in the Republic of Serbia, there is no possibility of paying for an organ transplant, and an organ cannot be smuggled,” Dr Rondović pointed out.

A HUMANE THING TO DO

‘Religious communities should take part’

Dr Rondović made a point of saying that religious communities must take part in this process.

“Organ donation is a humane thing to do, and religion itself promotes humanity and helping people, so there is no reason for the religious leaders or religious communities not be included in this process,” Dr Rondović said.

After each transplant, he added, they go public with the data about what has been done and where.

“If, for example, organs have been explanted at the MMA, it doesn’t mean that all the operations will be conducted here. The MMA currently does kidney and liver transplants, and we are the only liver transplant centre. The heart goes to the UMC Serbia’s Second Surgical Clinic, which is at the moment the only heart transplant centre. Kidney transplants are performed at the UMC Vojvodina as well. We also do retina transplants. As the programme expands, there will be centres for transplanting solid organs in Serbia, and it will be precisely known where which organ goes,” Dr Rondović concluded.

Kurir.rs/ J. S. Spasić