From 2021 to June 1, 2025, the National Scientific Center for Surgery and Transplantation named after O.O. Shalimov performed about 250 organ transplants from a deceased donor. Serhiy Palyanytsia, transplant coordinator of the National Scientific Center for Surgery and Transplantation named after O.O. Shalimov, told UNN about this in an interview and explained the difficulties faced by doctors in Ukraine in the field of posthumous donation.
- What are the conditions and requirements for using an organ for transplantation from a deceased donor?
Let's start with the fact that only a deceased person with a diagnosis of "brain death" is called a potential donor. The determination of brain death is carried out by a council of doctors, which cannot include transplant surgeons.
After the determination of brain death, a set of additional examinations is carried out to confirm the possibility of further transplantation. After confirming the existence of an application for consent to removal and confirming the suitability of organs for transplantation, a person is called a donor.
A donor can be:
- an adult who made a statement during his lifetime consenting to be a donor after death;
- a written statement of consent is submitted to the transplant coordinator of any transplantation center. On the basis of the application, a corresponding card will be formed in the EDICT;
- only those organs are removed that were allowed to be removed either by the deceased person during their lifetime, or by relatives, which is directly reflected in the corresponding application;
- during life, one can repeatedly change one's decision, which in turn cancels the previous application.
The donor's organs are removed by a team of doctors. Sometimes the number of doctors in the team can reach up to 14 specialists. After removal, an act is drawn up, which is signed by the doctors of the team.
In the case of a prescribed forensic medical examination, a forensic medical expert is present during the removal of organs, who may provide a reasoned objection to the removal. Such an objection is given only when the removal of organs may interfere with determining the cause of death of the deceased.
Information about the removal of organs is entered by the transplant coordinator in the EDICT. After that, the EDICT performs an initial comparison of donor-recipient pairs, which guarantees the equality of recipients in receiving anatomical material, because such a comparison takes place according to the same rules defined by the legislation of Ukraine.
Respect for the honor and dignity of the donor is always the main priority.
- What are the restrictions for donors?
Absolute contraindications to posthumous donation of anatomical materials are: HIV infection, AIDS, congenital or acquired syphilis, viral hepatitis, all forms of tuberculosis, brucellosis, typhus, tularemia, leprosy, Creutzfeldt-Jakob disease, echinococcosis, toxoplasmosis, filariasis, rishta, leishmaniasis.
In addition, there are categories of persons who cannot be posthumous organ donors, these are orphans; people recognized as incapacitated; those whose identity is not established. The law also clearly stipulates that military personnel who died during combat operations cannot be posthumous donors.
- What difficulties and nuances do doctors in Ukraine face in the field of posthumous donation? Are there any points that still need to be regulated at the legislative level?
Doctors face several difficulties and nuances.
First, it is a system of presumption of disagreement.
In Ukraine, there is a presumption of disagreement with posthumous donation, that is, a person can become an organ donor only if there is a written consent during life or the consent of close relatives after death. This complicates the processes, because it is often difficult for families to make such a decision, especially in a stressful situation. It is recommended to change the system of permission for posthumous donation at the legislative level, switching to a system where a person automatically becomes a donor, unless he or she has expressed the opposite during his or her lifetime.
Doctors also face distrust and underestimation of society.
There is distrust of transplantation in society (due to insufficiently active explanation of the functioning transplantation mechanisms, complex medical terminology), as well as the importance of posthumous donation is underestimated. .
Another important aspect is the limited possibilities of mobilizing resources. That is, an insufficient number of trained transplant coordinators and organ procurement bases, as well as limited budgetary funds to support donor activities.
Inertia of medical workers regarding the diagnosis of brain death.
Specialists from donor organ procurement bases who diagnose brain death in a potential donor and conduct the entire range of necessary examinations should be motivated to support their maximum involvement in the transplantation process.
It is necessary to create a system of exchange of experience and information between doctors, as well as to increase the level of qualification of medical personnel, including middle and junior staff.
No less important is the need to improve funding and infrastructure. It is necessary to increase the number of transplant organ procurement bases and equip them with the necessary equipment, as well as to create a unified national system that would unite all centers.
- How many organ transplants from deceased donors have been performed by the National Scientific Center for Surgery and Transplantation named after O.O. Shalimov since 2020?
In 2021, 43 cadaveric transplants were performed. Most often - liver. Mainly adults - children are observed and operated on mainly in Okhmatdyt. From 2022 to June 1, 2025, 206 cadaveric transplants were performed. More kidneys.
Today, the "National Scientific Center for Surgery and Transplantation named after O.O. Shalimov" systematically performs transplants of heart, kidneys, liver from both living and deceased donors. Organ transplantation operations are performed in 3 specialized departments:
- kidney transplantation;
- surgery and liver transplantation;
- heart transplantation and surgery.
The first kidney transplants in the Center were performed in the early 90s of the last century under the leadership of Professor Yevhen Baran. In 2001, Professor Valery Saenko and Professor Oleg Kotenko performed the first transplantation of a part of the liver from a living related donor in Ukraine in our Center. In the same 2001, Professor Borys Todurov performed the first heart transplant.
In 2004, the first hand transplantation - it was carried out by Professor Serhiy Halych. In 2005, the first simultaneous transplantation of a part of the pancreas and kidney from a related donor was performed by a team of specialists under the leadership of the professor. And in 2016, Professor Andriy Sydyuk, under the leadership of Academician Oleksandr Usenko, performed the first lung transplant from related donors.
The first split - liver transplantation (split-transplantation means that the organ from one donor was divided and transplanted to two recipients - ed.) by the teams of the Center and the First TMO of Lviv under the leadership of PhD Oleksandr Grynenko took place in 2023.
We perform extremely complex liver transplants for children 0+.
We also perform systemic kidney transplants for children, and AB0 incompatible (in the case when the blood groups of the donor and recipient do not match - ed.) kidney transplants from a related donor.
It should be added that the donor kidney retrieval from a related donor is performed as atraumatically as possible using the laparoscopic method. And tissue typing (genetic selection of the most compatible donor-recipient pair) is carried out on the most modern equipment.
The advantage of the Center is significant clinical experience, professionalism and dedication of employees to their work, multidisciplinary clinical activity, readiness to solve any medical problems.
There are currently 806 recipients on the Center's waiting list.
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