FAQ / Frequently Asked Questions
It is the method of choice for treating chronic failure of vital organs. Functional organ from a living or deceased donor is inserted in operation into the recipient’s body. Heart and liver replace the affected organ (orthotopic transplant). Recipient’s nonfunctional kidney must be left in its original location, unless there is a compelling reason for the removal and donor kidney was transplanted to the anterior lumbar pit (heterotopic transplant). In an uncomplicated course of the patient stays in the hospital about two weeks.
As for SR, the kidneys are transplanted in transplantation centers in Bratislava, Banská Bystrica, Martin and Košice. The heart is transplanted in Bratislava, the liver in Bratislava and Banská Bystrica.
- The heart and liver transplantation is a life-saving operation
- The kidney transplantation gives the patient a better life quality and more freedom
- Dietary measures after transplantation are less demanding than during dialysis
- The Transplantation Treatment is expensive, but finally less expensive than dialysis
This is a list of patients waiting for transplantation. The waiting list is not simply a waiting list, choosing a pair of donor – recipient is based on defined criteria. The basic principle is the best survival of the transplanted organ and the recipient. In the selection a blood group relation is considering, as for the heart and liver it’s adequate organ size. As for the heart and kidneys, the anti-HLA antibody assay is considering. As for the kidneys, the important is relation in transplantation antigens (HLA). An important criteria is the cross-match (test) negativity. For the above reasons, someone is waiting for an organ shorter or longer time. If the patient is at risk of life, he enjoys priority over the others, we call that the urgent or superurgent patient.
Candidate to an organ transplantation becomes the patient who agrees with transplantation and for which it’s medically possible. As for listening on the waiting list for a heart and liver transplantation it’s deciding by indication Commission of the competent transplant center. As for listening on the waiting list for a kidney transplantation, it’s deciding by dialysis center doctor, in case of the complicated health condition it’s going after the consultation with a doctor of competent transplant center.
It’s going about complete and irreversible extinction of all brain functions. Contrary of the patient in a coma, which is legally considered to be alive, the patient with brain death has not be revived by any equipments. The alleged donation is considered only after the determination of brain death. Methods and criteria for the brain death determining in our country are legislatively given (see more in “legislation”).
Deceased donor fo organs becomes the one with whom brain death has been established and where the organs contrary of the brain are not damage. Donors can not become a person who had a malignant or a serious infectious disease.
As for the heart and liver, we do not have at present a technology that would be able to replace in the long term the function of failured organ. As for the kidneys, it’s hemodialysis, but it requires regular commuting several times a week to a hemodialysis center. Quality of life after transplantation is diametrically different. Deceased donors are currently the main and as for the heart the only source of donated organs.
In our conditions, the living donor can become close genetic kin, husband, wife and emotionally close unrelated man. Some health criteria must be meet, a donor has to be informed about the procedure risks and has to consent to the kidney removal (which is always free). It requires the written consent of the donor and recipient to removal and transplantation. Kidneys removal from underages and under restraint individuals is forbidden. The second kidney of donor must be healthy and fully functional, blood group of the donor and recipient must be compatible with one another. Sale of kidney to a stranger in our country (as in all developed countries) is forbidden.
- Healthy adult blood relative, partner or friend, capable of general anesthesia
- The presence of two healthy kidneys
- The blood type relation and negative cross-match
- The absence of disease, that could cause recipient’s kidney failure
- Consent for the organ donation must be voluntary and informed
- Simple timing even before starting dialysis
- Better kidney function start
- Longer kidney survival
HLA typing is a test providing transplant HLA antigens. HLA antigens are special structures on the cells surface responsible for transplant rejection. Before each kidney transplantation the first is HLA antigens typing of the donor and this is entered into a computer choosing based on match of that the appropriate recipients from the waiting list.
The organism produces antibodies in response to foreign unknown proteins. The antibodies are created within infections, pregnancy, after the transfusion and after the transplant. They protect the body against injury. The one whom body has made antibodies against lymphocytes (part of the white blood cells) often has a positive cross-match and thus he’s automatically out of the selection of appropriate recipients because of the hyperacute rejection risk (very rapid kidney rejection), no matter the similarity of HLA antigens. Such patients are usually waiting for a kidney at longest.
Cross-match is a laboratory method, which is performed before transplantation to find out the risk of transplant rejection. It’s something like “Tube transplantation”, when recipient serum (non-cellular part of blood, which contains antibodies) is mixing with donor lymphocytes (there are a signs of antigens on those, against which antibodies can be formed). The test is considered to be positive, if the patient shows the antibodies against donor lymphocytes. Patients with positive cross-match can not be transplanted because they very probably quickly reject a kidney.
There is implied consent principle in force in Slovakia. It means, that after death, everybody’s a potential donor, if he meets the strict criteria for organ donation. There’s no need to consent to organ donation. In regard to the present legislation, there’s not a register of persons willing to donate organs in Slovakia.
The right of every citizen is to refuse to donate an organ, tissues and cells after death. Register of persons, who refused the donation of organs, tissues and cells after death, is keeping in the National Transplant Organization (NTO). In refusing the donation of organs, tissues and cells you need to fill out a form, which is found in the section “Downloads”, verify your signature a notary and sent to the National Transplant Organisation address. As for children, disagreement is signing by parents or legal guardian. After inclusion in the database, NTO sends the affirmation of inclusion in the register with the assigned identification number. Before removal each workplace indicating the donor, verifies its absence in the register of persons, who refuse organ donation.