“It was as if I had won the lottery! Incredible! I had been on dialysis for nearly five years and had lost all hope. I wasn’t expecting a call at all, and then the cell rang while I was in an ambulance! And here I am, with a new kidney and a new life, tomorrow I’ll probably go home too,” Vesna Papić, who we visited at The Military Medical Academy, where she had a kidney transplant performed on 31 July, said yesterday for Kurir, smiling.
Vesna is the fifth patient that a deceased-donor kidney transplant has been performed on since the beginning of the year, i.e. an organ coming from a deceased donor was transplanted into her. Fate would have it that there was no suitable recipient in the territory of Vojvodina for one of two kidneys of a brain-dead patient who had died at the UMC Vojvodina on 30 July. A call was placed from Novi sad to the MMA, saying, “We have a kidney for you.”
“On the previous day, I’d arrived from a spa – I was on a short vacation. I went on dialysis in the morning, and just when the ambulance was returning me home, I received a call to go to the MMA. I couldn’t believe it! When I got to the MMA, there were other candidates for that kidney, but I suppose my results were a match. And here I am, I still cannot believe that I have a new life,” Vesna, who was now casually doing crossword puzzles in her hospital bed, told us.
She is a nurse by profession and very aware of how important organ donation is and how big a problem it is in Serbia. This is precisely why she stood before our camera – for people to see that someone’s “yes” at the most difficult of times, when they are losing a person close to them, also means a new life – saving a few lives.
“Organ donation is very important. Dialysis is mere survival. This is something completely different,” Vesna noted, grateful to the donor family and everyone at the MMA.
At the MMA Transplant Centre, through which we were being led by Dr Mirko Jovanović, urologist and Lieutenant Colonel, who is the director of the Centre and does kidney transplants, there is a child as well – a 17-year-old teenager – and a man. These two lives have been saved owing to the humanity of a family whose member had died on 28 July at the UMC Kragujevac. Only a day later, two kidney transplants were performed at the MMA. Furthermore, a heart transplant was performed at the UMC Serbia.
TRANSPLANTS AT THE MMA
- 1971: corneas transplanted first; so far, 202 transplants performed
- 1972: stem cells transplanted first; so far, over 1,600 transplants performed
- 1996: kidneys transplanted first; so far, 497 genetically related and deceased-donor transplants performed
- 2005: livers transplanted first; so far, 42 transplants performed
The transplant procedure is initiated only when brain death is established, i.e. when the authorized committee determines it following the protocol.
“Up until the time of establishing brain death, a person is treated in the best possible way and all assistance is provided to him or her in order to be cured. However, if this fails, we initiate the transplant procedure upon declaring the person dead and with the consent of the family,” Dr Jovanović pointed out, adding that in order to perform a kidney transplant, a maximum of 36 hours can pass between the explantation, i.e. the removal of the organ from the donor, and the transplant surgery itself, as 36 hours is the maximum safe cold storage time for a kidney, while the maximum for the liver is only five hours.
According to Dr Jovanović, it is important for every patient who is on dialysis or waiting for a kidney transplant to get the organ as soon as possible.
“Dialysis is an important therapeutical procedure, but in the long term, it results in complications – loss of vision and muscle mass, disrupting the metabolic process, exhausting the body, causing a coagulation disorder and bleeding, vascular complications due to the formation of the dialysis pathway. In some patients, further dialysis is even impossible because a vascular pathway can no longer be formed for it,” remarked Dr Jovanović, adding that after a transplant, the person in question can go back to all his or her regular activities, which they cannot do with dialysis, as they are bound to their place of residence and go on a four-hour-long dialysis three or four times per week.
Furthermore, a dialysis programme is far more expensive for the system than a transplant.
“The most important thing is for the procedure of selecting the receiver to be initiated immediately upon being notified that there is a suitable organ donor. The procedure is routine, has a protocol, but is time-consuming. You need to know the donor’s blood type, as well as their virological and immunological status, and then the selection of the recipient begins. We can see straightaway on the lists which one is suitable, but additional analyses must be run for the recipient too. This is why we call as many available recipients on the list as possible, and determine based on the analyses who is the most suitable for the given organ,” said Dr Jovanović.
TRANSPLANTS AT THE MMA IN 2023
9 deceased-donor transplants total (five kidneys and four livers)
10 living-donor, genetically related kidney transplants
33 stem cell transplants (seven allogeneic and 26 autologous)
According to Dr Jovanović, it is not difficult to find a suitable organ recipient as the list is updated weekly, but it is difficult to find a donor, i.e. an organ.
“We must educate the entire population, so that people understand how important a transplant is for patients who have no other treatment options – it saves or prolongs life. People need to know that organ donation is a humane gesture and a noble act. The family of the deceased is grief-stricken at the time, and under the law they must give their consent for removing the organ of the deceased family member. But this noble act is very valuable for one or more recipients, as kidneys, the heart, the liver, the lungs, the pancreas, and corneas can be transplanted,” Dr Jovanović explained, adding that it is planned that Serbia too starts performing lung and pancreas transplants.
Kurir.rs/Jelena S. Spasić
