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Legal Regulations Regarding Transplantation - In Poland, Germany and Switzerland

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Huzarska D., Huzarska J., Pędziński L., Sowa P., Szpak A.
Polish Journal of Public Health
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2015
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vol. 124
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issue 4
169-173
EN
Introduction. Transplantation surgery, involving transplantation of cells, tissues and organs, constitutes a common medical practice that saves the lives of a great number of patients. Aim. The purpose of the present paper is to provide a comparative analysis of the legal regulations regarding transplantation that are in practice inside three European countries: Poland and Germany - EU Member States - and Switzerland - a non-EU state. The considerations made herein are meant to find an answer to the question whether the provisions of law regarding transplantation in the specified European countries regulate the legal situation of the donor and the recipient in a similar manner. Material and methods. The paper is based on the following source documents: The Cell, Tissue and Organ Recovery, Storage and Transplantation Act of July 1, 2005; The Act on Donation, Recovery and Transplantation of Organs and Tissues of November 5, 1997 (Transplantation Act - TPG); Federal Act on Transplantation of Organs, Tissues and Cells of October 8, 2004. In our work, we applied two methods, the first being comparative, and the second being dogmatic-legal. The latter consists of analyzing the provisions regarding transplantation as found within the three selected European countries. Results and Discussion. Under Polish, German and Swiss law alike, the recovery of cells, tissues and organs is allowed from an adult, who, under the Polish and German Acts, has full capacity to enter into legal transactions, and who, under the Swiss Act - is an adult who is mentally competent. Of note is that a minor might only be a donor in ex vivo transplantation provided that precisely specified requirements are met. Of additional note is that, under the German and Swiss Acts, recovery of tissues and organs from a human cadaver donor is allowed only if this person gave consent for such recovery prior to their death; under the Polish Act, this is allowed unless the deceased person expressed their objection when alive. Conclusion. As far as ex vivo transplantation is concerned, the legal solutions regarding transplantation in Poland, Germany and Switzerland regulate the legal situation of the donor and the recipient of a transplant in a similar way, although there are a few significant differences. As for ex mortuo transplantations - the legal solutions applied in each country greatly differ.
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Autogenous transplants of adrenal fragments in an animal model

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Dworzyńska A., Paduszyńska K., Pomorski L.
Polish Journal of Surgery
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2018
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vol. 90(4)
22-28
EN
Introduction: Adrenal insufficiency is a typical complication after surgical treatment of adrenal tumors, especially after the removal of both adrenal glands. Human beings are not able to survive without adrenal glands and without proper hormonal substitution. Autotransplantation of a fragment of the adrenal gland may prevent this complication. This can be done by transplanting the entire adrenal glands or its fragment, such as the adrenal cortex cells. In the case of adrenal tumors, the entire adrenal gland can not be transplanted. However, it is possible to transplant cells from the tumor-free part. Successful adrenal autografts may result in a new treatment of adrenal insufficiency. Materials and Methods: Autograft transplantation was performed on 3 groups of Sprague Dawley rats. In the first group, physiological corticosterone concentrations were determined. These animals were not operated. In the second group, both adrenal glands were removed. Corticosterone concentrations were determined after bilateral adrenalectomy. The third group was divided into two parts. In the first subgroup, bilateral adrenalectomy was performed simultaneously with adrenal transplant into the omentum. In the second subgroup, right adrenalectomy was performed simultaneously with and adrenal transplant into the omentum followed a month later by left adrenalectomy. During the experiment, corticosterone concentrations were measured at 4 time points. Results: The statistical difference between corticosterone concentrations in rats after two timed adrenalectomies and rats after bilateral adrenalectomy was statistically different, but these results were far from physiological concentrations.
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Laparoscopic Live-Donor Nephrectomy With Retroperitoneoscopic Access

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Słojewski M., Śluzar T., Umiński M., Sikorski A.
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EN
Live donation remains the single most consistent factor affecting long-term results of the transplantation. Open live donor nephrectomy is associated with high traumatization and possibility of complications due to large skin incision. The alternative is laparoscopic live donor nephrectomy (LDN) which is widely used in many countries. We present the case of LDN. The retroperitoneal approach was applied and time of operation was 210 min. The immediate function of transplanted kidney was observed. Authors hope that the offering this minimally invasive procedure to the potential donors may popularize the idea of live donation in Poland.
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Assessment of medical personnel knowledge about the function of transplant coordinator with reference to current Polish legislation

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Watrakiewicz-Hurko O., Belowska J., Sienkiewicz Z., Dykowska G., Gotlib J.
Polish Journal of Public Health
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2015
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vol. 124
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issue 1
14-20
EN
Introduction. Initially, a transplant coordinator assisted in the process of removal and transplantation of organs. The most important rule in the Polish legislation is the Act of July 17th, 2009, amending the Act on removal, preservation, and transplantation of cells, tissues, and organs. Professional qualifications of a transplant coordinator are specified by the Regulation of the Minister of Health of December 4th, 2009 on detailed conditions of removal, preservation, and transplantation of cells, tissues, and organs. Aim. The study aimed to assess the knowledge of medical personnel about the function of a transplant coordinator with reference to the current Polish legislation. Material and methods. The study was conducted in April 2013 among 100 selected health professionals (25 physicians, 62 nurses, and 13 persons representing other medical professions) with the use of a questionnaire comprising 42 close-ended simple choice questions and one multiple-choice question. They were referring to various aspects associated with the legal axiology of transplantation, procedure of organ donation, and tasks of a donation coordinator, as well as one open-ended question about the age of respondents. Results. Statistically significant differences between the occupational groups were found in relation to questions about legal and medical aspects. As many as 21 nurses (34%), 26 physicians (92%), and 6 persons representing other medical professions (46%) (p<0.000) provided the correct answer to a question referring to determination of death, and 19 nurses (31%), 7 physicians (28%), and 5 persons representing other medical professions (p<0.021) answered correctly to a question about the key premise to determine brain death. Conclusions. 1. The knowledge of medical personnel about the function of a transplant coordinator and the legal provisions concerning brain death determination needs to be supplemented. 2. There is a need of constantly supplementing knowledge of medical personnel about the clinical aspects of transplantation
5
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Wiedza i opinie studentów na temat transplantacji narządów

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Kamińska M., Daszuta K.
Innowacje w Pielęgniarstwie i Naukach o Zdrowiu
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2019
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vol. 4
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issue 2
53-70
EN
Introduction. Transplantation of organs, cells and tissues is a recognized method of treating patients with end-stage organ failure. The aim. The aim of the study was to compare the knowledge and opinions of students of the State Higher Vocational School in Włocławek and respondents of the Center for Public Opinion Research (CBOS) on organ transplantation. Material and methods. The research was conducted among 80 students of the State Higher Vocational School in Włocławek. The method of diagnostic survey, questionnaire technique and author's questionnaire was used. Results. Most students declare their willingness to donate their organs for transplantation after their death. Similarly, a significant percentage of Poles show insufficient knowledge about organ transplantation and legal regulations. Conclusions. The attitude of the PWSZ students in Włocławek and the majority of Poles towards organ transplants is positive. There is a need to promote the idea of transplantology and knowledge about the principles of transplantation of organs, tissues and cells.
PL
Wstęp. Transplantacja narządów, komórek i tkanek to uznana metoda leczenia pacjentów w ze schyłkową niewydolnością narządów. Cel. Celem badań było porównanie wiedzy i opinii studentów Państwowej Wyższej Szkoły Zawodowej we Włocławku oraz respondentów Centrum Badania Opinii Społecznej (CBOS) na temat transplantacji narządów. Materiał i metody. Badania przeprowadzono wśród 80 studentów Państwowej Wyższej Szkoły Zawodowej we Włocławku. Wykorzystano metodę sondażu diagnostycznego, technikę ankietowania oraz autorski kwestionariusz ankiety. Wyniki. Studenci w większości deklarują gotowość oddania własnych narządów do transplantacji po swojej śmierci. Podobnie jak znaczny odsetek Polaków wykazują jednak niedostatki wiedzy na temat transplantacji narządów i regulacji prawnych. Wnioski. Stosunek studentów PWSZ we Włocławku jak i większości Polaków wobec transplantacji narządów jest pozytywny. Istnieje potrzeba propagowania idei transplantologii oraz wiedzy na temat zasad przeszczepiania narządów, tkanek i komórek.
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The Cartesian concept of corporeality and medical practice

63%
Raniszewska-Wyrwa A.
Physiotherapy
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2010
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vol. 18
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issue 3
46-51
PL
Antropologia Kartezjusza dała trwały wkład w rozumienie ludzkiej cielesności, stając się czynnikiem wyznaczającym kierunek działań praktycznych, mających na celu wypracowanie coraz to bardziej skutecznych metod terapeutycznych. Zgodnie z koncepcją mechanistyczną w medycynie ciało traktowane jest jak biomaszyna, która realizuje określone cele. Zdrowie rozumiane jest jako prawidłowe funkcjonowanie maszyny cielesnej, choroba - jako zakłócenie naturalnych funkcji organizmu. Medycyna dokonuje zatem biologicznej redukcji pojęcia choroby, przyjmuje praktyczną jej koncepcję. Leczenie polega na naprawianiu organizmu za pomocą usuwania wadliwych części lub niszczeniu ciał obcych. Mechanistyczna koncepcja cielesności może być również odniesieniem dla chirurgii transplantacyjnej; skoro organizm ludzki jest maszyną, układem powiązanych z sobą elementów, to lekarz dokonując działań polegających na wymianie uszkodzonych części, podejmuje działania czysto mechaniczne. W biomedycznym modelu leczenia (opierającym się na mechanistycznej koncepcji cielesności) w centrum uwagi lekarza pozostaje niewłaściwie funkcjonujący organizm biologiczny, zanika natomiast pacjent jako osoba, co może spowodować u niego poczucie marginalizacji i zredukowania do kolejnego przypadku chorobowego, a to z kolei wpłynąć negatywnie na ogólny stan chorego. Taka sytuacja może być korzystna dla pacjentów nie chcących ujawniać prawdziwego stosunku do choroby. Model biomedyczny może być też wygodniejszy dla personelu medycznego, który nie wchodząc w głębsze relacje z pacjentami, może zdystansować się do problemu bólu i cierpienia chorego.
EN
The anthropology of Descartes permanently influenced the understanding of human corporeality by becoming a factor outlining the direction of practical actions aiming at finding more effective therapeutic methods. According to the mechanistic concept in medicine the body is a bio-machine that performs specified functions. Health is understood as proper functioning of the bodily machine, sickness is a disturbance of the natural functions of the organism. Thus medicine conducts a biological reduction of the notion of sickness and embraces the practical concept. Treating is repairing the body through removing defective parts or destroying foreign bodies. The mechanistic concept of corporeality may also be a reference for transplantation surgery; if the human body is a machine, a system of inter-connected elements, then by replacing defective parts doctors conduct purely mechanical activities. In the biomedical model of treatment (basing on the mechanistic concept of corporeality) the doctor's attention is focused on the defective biological organism, however, the patient as a person disappears. This may cause a feeling of marginalisation and reduction to just another case, and this in turn may negatively influence the general state of the sick. On the other hand such a situation may be favourable for patients who do not want to disclose their real attitude towards a new situation. The biomedical model may be also more convenient for the medical personnel as without building deeper relations with the patients they are able to distance themselves from the problem of pain and suffering of the sick.
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