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Why have I decided to become a donor?
The Importance of Transplantation
Chief Physician, Čedomir Topuzović, Head of the Kidney Transplantation Centre
The Importance of Transplantation
Transplantation of kidneys is the best method of treating patients in the terminal stage of chronic renal insufficiency. Apart from transplantation, the only alternative treatment is dialysis. Patients waiting for transplantation of kidneys differ from patients waiting for transplantation of heart or liver - because there is no other salvation, but transplantation, for the persons needing liver of heart. ’Mechanic pump’ can replace the transplanted heart, but only for a short period.

There are nearly 6,000 patients in the Republic of Serbia undergoing a chronic dialysis programme and this number is only increasing year in year out. The greatest number of patients, about 90 percent of them, are on haemodialysis, while the rest of them are on peritoneal dialysis.

About 800 patients are currently waiting for a new kidney in Serbia. As the number of patients on dialysis is increasing, there are more and more people waiting for kidney transplantation. Unfortunately, due to chronic shortage of organs for transplantation and morbidity of the dialysis itself, the great number of patients from the waiting list for transplantation never live up to receive a new organ. A share of patients dies, while the rest of them are removed from the list due to different illnesses which develop due to their sick organ and developed ineligibility for transplantation.

There are numerous advantages of kidney transplantation over dialysis. It significantly prolongs life, improves the quality of life, but it is also more cost-effective.

Patients on dialysis spend the greatest part of their life attached to instruments, because dialysis treatment is done three times a week in a duration of about 6 hours. Besides spending a lot of time in hospitals, patients on dialysis are restricted in many ways, in terms of their diet, intake of liquids and life habits. So, in addition of saving one’s life, transplantation brings patients complete social, medical and psychological rehabilitation, i.e. return to normal life.

Apart from being more favourable and healthier option for a patient, transplantation is also a more cost-effective option for the state, because it costs less than long-term dialysis. That’s why the kidney transplantation is regarded the best treatment for all the patients undergoing the terminal renal insufficiency.

The transplanted kidney completely replaces the renal function, as opposed to the dialysis that does it only partially. Correcting many disorders in chronic renal insufficiency that dialysis cannot correct, kidney transplantation reduces the mortality and morbidity of these patients. In patients with successful kidney transplantation the mortality is up to 50 percent lower than in patients on dialysis.

However, due to insufficient number of organs for transplantation, many patients spend years on dialysis waiting for the corresponding organ to be found for them, while many of them do not live enough to receive it.

Serbia ranks last in Europe in terms of transplantation number. While there are almost 40 donors per million inhabitants in Europe and member states of Eurotransplant, in Serbia we have 3 of them. According to parameters of Eurotransplant in Serbia, that has 7 million inhabitants, minimum 10 donors per one million of inhabitants should be on an annual level, while optimally, there should be many more donors who would provide for minimum 400 kidney transplantations, more than 150 liver transplantations and over 50 heart transplantations. But we are far from these figures.

Transplantation and increase of number of donors should be the priority of each state and its healthcare system. The right indication that Serbia is on the right track towards solving of this, for many the most important life problem is the adoption of new Law on Human Organs Transplantation which has been in force in Serbia since last year. It is a new chance for life for many patients waiting for transplantation, because it has been adopted in order to increase the number of donors.
Chief Physician, Čedomir Topuzović,
Head of the Kidney Transplantation Centre