Ukrainian surgeons, on Dec 24, performed a successful heart transplant surgery. The operation was the first of its kind in 15 years, due to a de facto ban on organ transplantation in Ukraine.

The parliament, on Dec. 20, passed a law systematizing the process of finding donors, easing the bureaucracy and creating an online database of donors by 2021. The law is awaiting the president’s signature.

While technically allowed since 1999, Ukraine lacked an official procedure to extract organs from deceased people, making it impossible to find donors needed for a heart transplant.

“In Ukraine, there are doctors who can perform a heart transplant surgery, but there isn’t a system that allows them to do so,” Iryna Zaslavets told the Kyiv Post.

Zaslavets is a journalist and a co-founder of IDonor, a non-profit organization tasked with drawing attention to the challenges of transplantology in Ukraine. In 2011, she herself was forced to pay 100,000 euros for a transplant of a spinal cord abroad, because it couldn’t be performed in Ukraine. In 2019, the state budget allocated Hr 700 million ($30 million) for Ukrainians to receive treatment non-existent in Ukraine, elsewhere. Among them were patients in need of a new heart.

Today, most transplant surgeries in Ukraine deal with living donors, usually family members who donate organs that can be extracted without lethal danger, such as a liver or a kidney.

Each year, over 5,000 Ukrainians need a transplant to survive, according to Deputy Health Minister Dmytro Koval. However, fewer than 2,500 transplants were performed since Ukraine’s independence in 1991. Only six of them were heart transplant surgeries.

Legislative changes

Back in 2018, the parliament passed a law introducing a mandatory donor registrar from Jan. 1, 2019. However, the system wasn’t ready on time, blocking even family organ donation.

In February 2019, then-President Petro Poroshenko signed a law postponing for a year the mandatory donor registrar.

Now the new parliament, elected on July 21, passed a law systematizing the donor-patient interaction.

The law introduces transplant coordinators who will oversee the transfer of organs from a dead person to a patient in need. The law also systemizes the process of declaring a person brain dead, paving way for his organs to be extracted. The process can now be done by certified surgeons with consent from relatives.

If the hospital lacks qualified personnel, it can invite a certified specialist from another clinic. The surgeons won’t be investigated for transplantation of organs, with the process from now on being managed by transplant coordinators.

“(Prior) surgeons didn’t want to take the risk,” says Zaslavets.

Currently, if the doctor chooses to skip bureaucratic procedures to perform transplant surgery, they can receive a 3-year prison sentence.

The Dec. 24 heart transplant surgery took place in Kovel, a city of 70,000 residents 450 kilometers west of Kyiv. It was performed by a team of surgeons led by Borys Todurov, head of the Kyiv Heart Institute, who traveled to the hospital for the surgery.

The heart was taken from a man who died in the same hospital. His family consented to donate his heart and kidneys.

The recipient of the heart was a middle-aged man whose identity wasn’t revealed. He appeared in the video posted by Zaslavets, recovering after the surgery and waving to the camera. The patient traveled for the surgery from Kyiv, because the heart couldn’t be brought to Kyiv, according to Todurov.

A video posted by Iryna Zaslavets shows the recipient of the donated heart recovering in the city hospital of Kovel with his family around him. Across the hallway, another patient recovers after getting a kidney transplant from the same donor.

“This was possible due to the change in regulations and the initiative of the young leadership of the Kovel city hospital which became among the first to receive a license to diagnose brain death,” says Zaslavets.

Since independence, only six heart transplants were done in Ukraine, all by Todurov. In 2016, Todurov implanted a mechanical heart.

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