The Condition of the Transplant Service in the Republic of Tajikistan

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Abstract

The National Scientific Center for Human Organs and Tissue Transplantation in Tajikistan is the only transplant centre which hosts both pediatric and adult organ transplant services under one roof. Established in 2010 under the Ministry of Health of the Republic of Tajikistan, the Transplantation Centre brings together an expert team of doctors all working together to provide expert care for organ transplant recipients and donors. During the last years of the functioning over 450 kidney transplants were performed in the centre and the most active period of transplantation was observed from 2016. The number of operations has increased by 80-85%, which is due to the positive results of the centers activities and consequently the increased confidence of the population. Despite such a progress the number of patients on dialysis exceeds the number of patients with a transplanted kidney due to a shortage of donor organs.

It is worth to mention that our center performs transplantation procedures not only for the national people but we provide medical aid for the patients from overseas who in need for transplantation surgery. Thus, citize ns of the Republic of Kyrgyzstan-30, Afghanistan-5, Uzbekistan-7, Turkmenistan-6, Sudan-3, Russia-3, Azerbaijan-21 and Israel-8 underwent kidney transplantation in the centre.

Most patients prior to the transplantation were on renal replacement therapy lasting from 1 to 24 months; 3.4% of patients underwent pre-dialysis kidney transplantation. Patients with chronic kidney disease resulted from the various pathological conditions such as glomerulonephritis, diabetic nephropathy, chronic pyelonephritis, polycystic kidney disease, urolithiasis were indicated for kidney transplantation. Most of transplantations were performed after identification of ABO donor-recipient compatibility classified according to recipient ABO blood group. Patients with a functioning renal transplant are considered under the supervision of specialists of our center. The indicators of postoperative survival of transplants and postoperative complications are comparable with the global ones. Moreover, nowadays in the Republic of Tajikistan, there is a real opportunity to provide a high-tech medical assistance in the form of liver transplantation to patients who were previously doomed to severe disability and imminent death. Within 2014-2017 more than 50 liver transplantations in patients with hepatic insufficiency was carried out. Five of them were performed in children. Recently in June, 2017 a department of bone marrow transplantation has opened in our centre where already two first patients underwent hematopoietic stem cell transplantation. In conclusion, the existing organizational structure of the transplantation service in Tajikistan allows the provision of qualified transplantation services to the population; however lack of corpse donation determines slow progress of the transplant service in the country.

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