Recently the RA Government approved the decision on "Approving the Order on Taking and Processing Transplantation Organs and Tissues from the Dead and the Order on Performing Transplantation".

The decision regulates the order and conditions for providing a permission to take organs and tissues from a dead donor. Thus, a number of mandatory requirements are specified and only when they are satisfied, a medical commission of experts is established by the order of the head of the medical institution at the dead donor's location, which carries out a thorough medical examination and gives a positive or negative conclusion on taking organs and tissues from the dead donor. Doctors who participate in the confirmation of brain death of the dead donor cannot be included in the commission.

According to the decision, an information database will be created at the Ministry of Health which will not register potential donors. The registry (information database) will have 3 sections: the first will include data on the RA citizens who refused to become donors when they were alive; the second section will include information on patients needing transplantation, and the third - cases of transplantation performed in the RA.

Professor Ashot Sargsyan, Doctor of Medicine, head of Nephrology Department of Arabkir Medical Complex, said that they perform 10-15 kidney transplantations a year but they can do more because there is demand for it. "What stops us is the absence of law, because today we do transplantations only using kidneys of donor-relatives. Very often, when no donors are found among the relatives, the patients stay without kidneys." Sargsyan noted that the donor may not be a relative, but it is important to exclude the factor of buying and selling, since it is prohibited by law; otherwise the poor always suffer. "We have not made transplantations from a dead donor yet because the draft has not become a law yet. After it is adopted, a long - 1-2 year preparation period will be needed." Sargsyan emphasized the importance of the law, which will allow to increase the number of transplantations.

He informed that since 2002 about 100 transplantations were performed at Arabkir Medical Complex and only 2 kidneys were lost which is a good result and evidence of well performed transplantations.

Ashot Sargsyan mentioned that today the price for kidney transplantation in Armenia is 7.5 million drams: one third is covered by state order, one third by Arabkir foundation and a third, which makes 2.5 million drams, is paid by the patient. Post-operational drugs are provided by the state free of charge.

Answering the question for what organs donors are needed, Ashot Sargsyan said that kidneys, liver, heart and lungs come first followed by intestine and bones, but kidneys are on the first place. "There are 60 patients at the dialysis department now; 40-50 of them need donors."

Despite the fact that Article 7 of the RA Law on Transplantation of Organs and/or Tissues to the Man says that organs for transplantation can be taken from dead people only when the person gave a written consent to it when he was alive, Zhora Khachatryan, member of Chamber of Advocates, says that practice shows that no one has given such a consent: "We don't have a single application from a living person giving consent to use his organ after his death," Khachatryan says mentioning that it is a problem the Government is trying to find a solution for in its draft amendments: "It is proposed to consider the absence of the living donor's objection as a consent; besides the issue of the position of the deceased relatives is specified." That is, even if the written consent of the living donor is absent, his organ can be taken after his death if his relatives give their agreement. Respectively, relatives can object transplantation and do not allow it even if there is a written consent of the living donor.

Confirmation of the fact of death is considered a precondition for consent for taking organs from a dead donor in the law (Article 8) which states that organs can be taken from a person after confirming the fact of his brain death. Answering the question if we do not have a problem of organ trafficking if organs can be taken after confirming brain death only, Mr. Khachatryan said that any act involves risk of abuse and corruption, and there is no sphere where the danger of falsifying this or that document is absent: "The question here is how such cases can be prevented. In this case, the objective of investigation bodies is to find out whether the document was falsified or not. If it is found that the agreement is falsified, such people will be brought to account."

Answering the question if Article 7 of the RA Law on Transplantation of Organs and/or Tissues to the Man contradicts Article 14 of the RA Constitution that states "Dignity of a person is respected and protected by the state", and Article 16 that states "Each person has a right for freedom and immunity", Khachatryan defined the written consent  of a person for the recovery of the health of a different person as a humanistic and not an anti-constitutional act. In his opinion, it does not insult in any way the dignity and honor of the dead person.

Khachatryan saw no problem here from the viewpoint of human rights. In his opinion the question simply is that as long as we do not have the consent of the living person to use his organs after his death, the right of a living person to get required medical aid is violated. "We are looking at the question from the viewpoint of the dead person but we have to look at it also from the viewpoint of the living person. Medical aid runs into impossibility and because of the absence of organs another person dies. I want people to think more about healthy people than about the dead," Khachatryan said and offered to discuss the process from the aspect of how efficiently dead peoples' organs can be used in the future.     

 Sona Adamyan

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