"In August of last year, it was Friday afternoon, they called me from the hospital with a question: 'Can you be in Minsk tomorrow morning?' A donor who suits you happened, the man had brain death,'' the president of the Association "Donation is Heroism" Ivana Jović, who received a kidney transplant, begins her story.
She continues: "I said: 'Of course' and then my agony begins - how can I get to Minsk in 15 hours, and at the same time there are no direct flights because of the sanctions they have".
With the money saved up, she barely managed to find a private flight – it was summer and everyone was booked. She flew to Lublin in Poland and landed at 11 o'clock in the evening. There was only one taxi driver in front of the airport and he agreed to take her to the border with Belarus. Since she cannot cross the border on foot, she asked the people who were waiting for her to cross with them.
"Of course, people are skeptical, I don't know Russian, I try to explain to them with my hands and feet. One man, a Belarusian, when I showed him the cover letter from the hospital, he agreed to cross the border with him", explains Ivana Jović.
After crossing the border, which lasted three hours, the driver from the hospital waited for them, and at nine in the morning she was in Minsk, Belarus. He also talks about how difficult it is that in a situation where you have the biggest problem, you don't have the support of your country, and that kidney transplantation "isn't news because it was done in our country 50 years ago."
Ivana Jović did the transplant in Belarus at her own expense, and she collected the funds with the help of humane citizens. He explains that cadaver transplants (from a deceased donor) are rarely allowed by foreigners because there are not so many organs, but that Belarus has such a law that 10 percent of cadaver transplants can be done to foreigners.
"You don't pay for the organ, but for the transplant itself," says Jović and adds that the preparations for the operation cost about 7000 dollars, the transplant between 70.000 and 80.000 dollars, but that these are not the only costs.
"You have to raise money for the translation of documents, to pay for a private flight. The private flight was 8000 euros, 200 euros taxi from the airport to the border, 500 euros transportation to the hospital. You are alone in everything", says Jović.
He points out that this is not the case only with adults, but that there are also about forty children in Serbia who are on dialysis and whose parents cannot donate an organ because they are not compatible, so they are waiting on a list - "neither do they have a childhood, nor a vacation".
Mladen Todić from the Association "Together for a New Life", who received a liver transplant in Serbia, says that he was put on the official waiting list in 2014 and that after two and a half years, at the last moment, a donor who was compatible with him came forward .
"There were not enough donors in Serbia to save everyone from the list. At that time, I had about a month, two days left to live", states Todić and says that it is an individual matter how long someone waits; he knows patients who have been waiting for a month, but also some who have been waiting for 9, 10 years. A certain woman, Todić points out, has been waiting for 40 years and has been on dialysis the whole time.
According to this interlocutor, there are about 1000 people on the waiting list for liver, heart, and kidney, and when corneas are added, there are about 2000 of them in total.
In addition to them, Todić states that there are also patients waiting for a lung transplant. However, since lung transplantation is not performed in Serbia, there is no official waiting list, and those patients in Serbia, says the interlocutor, are condemned to death.
INSUFFICIENT NUMBER OF TRANSPLANTS DONE
According to the International Registry of Organ Donation and Transplantation (IRODaT), Serbia is among the last on the scale of organ donation rates in the world. The Philippines, Nicaragua and Vietnam have a lower rate than Serbia.
During 2023, 32 cadaveric transplants from 12 donors were performed in Serbia, and during 2022, according to Ivana Jović, two transplants were performed. Our interlocutors state that the situation is not better in 2024 either, and that from October 2023 to April of this year, only two kidney transplants were performed from one donor.
The number of human organ donors/donors and the number of transplanted human organs in health institutions in Serbia has been falling in the last 10 years and was the highest in 2013 when there were 41 donors and 95 organ transplants.
"We have a large number of people who go and solve their problems in the region, in Belarus and wherever they can, because here it is certain that the majority of people will not receive that most important call", emphasizes Ivana Jović.
WHAT IS THE BIGGEST PROBLEM?
The first and basic problem, says Todić, is the lack of donors, and the number of consents for organ donation has been very low for years.
"Secondly, we believe that a transplant program cannot be based on one or two institutions. That is, last year the Clinical Center of Vojvodina worked the most, followed by the Clinical Center of Serbia in the context of obtaining consent for organ donation. In other centers where there are intensive care units and in hospitals that are called donor hospitals, there were no donors for a long period of time", indicates Todić.
He adds that as far as he knows, there are 14 coordinators appointed in different cities and in different institutions who should talk to families about consent to organ donation if brain death is diagnosed.
Ivana Jović says that in their association they are also advocating a coordinated approach to transplants in Serbia, which would mean, when the medical conditions are met, that the coordinators request the consent of the families for organ donation.
She points out the disorganized system as a key problem and says that in Serbia in three months there were only nine questions asked to families for consent.
"We now have a situation where we don't have a law for three years, so one of the goals of our association is definitely advocating the passing of a law on transplantation, but also raising awareness about the importance of organ donation," concludes Ivana Jović.
CITIZEN AWARENESS
In order to raise citizens' awareness of the importance of organ donation, it is necessary, he points out, to include all relevant factors of society - "first of all the state, the media, patients and the profession, and finally the church. As an association, we launched a campaign called 'You're still a trace of me', which aims to increase the number of transplants, and above all to raise the awareness of citizens and return this topic to the public's focus so that people understand that there is no mention of organ trafficking here.
The position of the Serbian Orthodox Church regarding the transplantation of organs and tissues from one person to another is that it is a matter of personal choice of each individual in consultation with a priest and a doctor. However, Mladen Todić emphasizes that it is necessary for the patriarch to come out officially with a positive attitude and cites the example of Pope John Paul II, who said in an Easter epistle that it is a sin to bury what can help the living, and that these words helped Catholic countries a lot.
OTHER COUNTRIES
"In Croatia, Italy, and Spain, which are now at the top in the world in terms of the number of transplants, after Pope Paul's statement, there was an expansion of the transplant and donor program," Todić points out.
Recently, a genetically modified pig's kidney was transplanted for the first time in a hospital in Massachusetts, USA. The hospital announced that this operation "marks a turning point in the search for the most available organs for patients."
A pig kidney, modified by Cambridge pharmaceutical company I Genesis by removing "harmful pig genes" and adding "human-compatible" genes, was transplanted during a four-hour operation to Richard Sleiman, who had end-stage kidney disease.
Jović concludes that it would be good for people to discuss organ donation and transplantation within their families.
"If it happens that families are asked that question 'tomorrow', they still have some awareness of what their family member's will was", says Jović. However, if the problem is not solved systematically and if there is no one to ask the families for their consent, awareness is raised in vain.
