Horror stories about transplantology

Someone else's heart
Even those who believe in "horror stories" about transplantology,
 for whom organ transplantation is the last hopeNadezhda Chetverkina, "Moscow News"

Transplantology is an area, as if purposely set aside, on the one hand, for real medical miracles to save the hopeless, and on the other – for rumors, speculation, gossip, blackmail, cheap and bad-smelling PR and such dense ignorance that you are simply amazed. How does it all get along with each other? Strangely enough, these two sides – exactly like two sides of the same coin – coexist calmly and ... in parallel.

Our foundation "Life as a Miracle", which helps children with severe liver diseases (including those where the only chance of salvation is a transplant), frighteningly often encounters in its work such an unwillingness to at least superficially familiarize itself with the problem that it is often impossible to even let alone some constructive dialogues, and the possibility of a conversation in principle. And after all, we are talking not only about residents of remote areas or elderly people, by no means. Quite young people and – moreover – some doctors in the regions have a very "specific" idea of what organ transplantation is and why it is needed.

Here are a number of common misconceptions: a person who has become a donor necessarily dies in a few years; the recipient becomes incapacitated and/or dies shortly after surgery; surgery can be adequately replaced with medication, blood transfusion (there are still options for homeopathy and healing); if a woman becomes a donor for her child, she will not have more children a girl who has undergone a transplant will not be able to become a mother in the future; an organ donor will live on pills all her life; a recipient will be bedridden for life… The list can go on indefinitely. Moreover, interestingly, examples from life that make it possible to verify the absolute capacity and "normality" of both donors and recipients convince not everyone. Often people make a skeptical expression on their face and stay with their own. And they continue to confess the monstrous and powerless "it's better to die than to suffer like this."

And do you know what the scariest thing is? That all this is said not only by those people whose illnesses have passed by. Parents of children who have very little time left to live without a liver transplant come with such questions. Holding yellow, exhausted babies with bellies swollen from ascites in their arms, parents are looking for other ways to the last and are afraid to "go under the knife". Doctors in hospitals on the periphery, instead of sending the baby with his parents to Moscow, where the child's life will be saved, keep him at home until the last, and then discharge him to die, because "nothing can be done." And more than half of the stories of successful rescue are the desire of parents to experience all the possibilities and do everything possible and even more. This is an independent search on the Internet for those who have already faced similar problems, clinics that treat detected diseases, these are calls to the fund with questions… But those who do it are few. Significantly fewer of those who do not and ... are afraid.

A reasonable question that sometimes has to be answered several times a day: "But if people are afraid, then it's not unreasonable"? We try to answer it honestly. And the honest answer is this. Yes, there is a risk (it exists with any complex treatment – this is if you do not go into sophistry and do not say that risk is generally an integral part of life). Moreover, the risk is greater for the recipient, and less for the donor. Any person with a transplanted organ (any, and not only with an organ) has a chance of rejection, both controlled and acute, which sometimes cannot be stopped, and then the only way out is re–transplantation. Yes, a person who has undergone a transplant is forced to take immunosuppressants all his life – drugs that reduce immunity. Precisely so that there would be no rejections. And by virtue of receiving immunosuppression, they are at risk for any flu epidemic, for example. But.

Children who have undergone transplantation can do almost everything that any other children can (with the exception of contact sports and strong sun). They go to a regular school, swim, ride a bike, draw, sing, dance, walk, fall in love. And girls, growing up, give birth to healthy children. Yes, they need special control, but they are not the only ones who need such control. "Do you understand what we are talking about? – we ask our parents. "Your child will be as healthy as he can be." And often we get a "punch in the gut": "I understand, I understand, but is there really no other way?"

Otherwise, very often it is really impossible. Otherwise, it is impossible if cirrhosis has started, because otherwise it cannot be treated. Otherwise, it is impossible if the child has specific genetic disorders that affect the functioning of the liver or lead to insufficient production of a particular enzyme, because in the vast majority of cases such disorders entail in the future disturbances in the central nervous system, in general physical development, in mental development, etc.

Transplantology, which is sometimes tried to be presented as a variant of medicine "from the evil one", has become a salvation for hundreds and hundreds of people who had no chance to survive 100 years ago – organ transplantation work began only at the beginning of the 20th century (although people began to think about this possibility much earlier). But the real triumph of transplantology happened in the 70s, when the first immunosuppressants appeared. People literally sentenced to death – with severe lesions of the kidneys, liver, heart, lungs, intestines (not to mention transplants of ligaments, joints, skin, etc.) – such people have the opportunity to live for decades!

In organ donation, human-to-human transplantation is most often performed (although scientists are actively working to replace human organs with artificial ones, including those grown from stem cells, at least in some cases). Transplantation takes place either from a living donor or from a deceased one (so-called cadaveric transplantation). It is obvious that either a paired organ (kidneys, lungs) or a recovering one (liver) can be transplanted from a living donor. A heart transplant, for example, can only be performed from a deceased person.

I would like to stop here, because the issues of cadaver donation (and "horror stories" about "black transplantology") require a separate conversation. I want to dedicate my next column to him.

In the meantime, summing up, I can remind everyone of the old and exceptionally true motto: "Knowledge is power." It is impossible to fight ignorance with declarations or laws, but you can defeat it with explanations. As a dubious consolation, I can say that transplantology is feared not only in Russia – most people around the world are afraid of surgeries, doctors and complex treatment. There are not enough organ donors around the world. Probably, the difference is that in developed countries, active work is being done by the state to combat medical ignorance, and we are not doing very well with this yet. But in any case, I am sure that there is only one way out of this situation – to tell. To tell everyone who wants to hear about all aspects related to transplantology – not with a fantasy or a "horror story", but with a complex surgical operation that allows you to save the life of a person who nothing else can help.

Portal "Eternal youth" http://vechnayamolodost.ru25.06.2012