Spasovski Goce, Busic Mirela, Delmonico Francis
Department of Nephrology, University of Skopje, Skopje, Macedonia; Steering Committee, South-Eastern Europe Health Network Regional Health Development Center on Deceased Donation and Transplant Medicine, Skopje, Macedonia.
South-Eastern Europe Health Network Regional Health Development Center on Deceased Donation and Transplant Medicine , Ministry of Health , Zagreb , Croatia.
Clin Kidney J. 2016 Feb;9(1):172-5. doi: 10.1093/ckj/sfv116. Epub 2015 Nov 24.
Due to the limited access to kidney transplantation (KTx) in developing countries, desperate patients have engaged in the purchase and sale of kidneys. In 2004, the World Health Assembly urged member states to protect the poor and vulnerable from being exploited through practices of illegal organ trafficking that had become widespread throughout the world. In 2008, the international transplant community convened a summit of transplant professionals, legal experts and ethicists to combat organ trafficking, transplant tourism and transplant commercialism that resulted in the Declaration of Istanbul (DOI). The South-Eastern Europe Health Network (SEEHN) represents a nine country multigovernmental collaboration on health systems. The Regional Health Development Centre on Organ Donation and Transplant Medicine (RHDC) was established in 2011 in Croatia to facilitate cooperation among south-eastern European countries to improve organ transplantation within the Balkan region. Since 2011, a collaboration between the RHDC, the Custodian Group of the DOI (DICG) and SEEHN professionals has enhanced strategic planning and definition of country-specific action plan priorities on organ donation and transplantation. Data of kidney transplantation provided in this report show a significant increase in transplantation activities in a 4-year period in Macedonia, Moldova, Bosnia and Hercegovina, Romania and Montenegro. The success of the donation and transplantation programmes was influenced by the engagement of key professionals and the establishment of organizational infrastructure with the implementation of an appropriate funding model. In conclusion, the DOI has provided an ethical framework for engagement of health professionals from south-eastern European countries. The newly established SEEHN RHDC as a technical coordinating body greatly contributed in building institutional capacity and strengthening regional collaboration between health authorities and professionals within these countries for improvement of transplant activities in the Balkans.
由于发展中国家肾移植（KTx）的可及性有限，绝望的患者参与了肾脏买卖。2004年，世界卫生大会敦促成员国保护穷人和弱势群体，使其免受已在全球广泛传播的非法器官贩运行为的剥削。2008年，国际移植界召集了移植专业人员、法律专家和伦理学家峰会，以打击器官贩运、移植旅游和移植商业化，由此产生了《伊斯坦布尔宣言》（DOI）。东南欧卫生网络（SEEHN）代表了九个国家在卫生系统方面的多政府合作。2011年在克罗地亚成立了器官捐赠与移植医学区域卫生发展中心（RHDC），以促进东南欧国家之间的合作，改善巴尔干地区的器官移植情况。自2011年以来，RHDC、DOI保管小组（DICG）和SEEHN专业人员之间的合作加强了器官捐赠和移植方面针对具体国家的行动计划优先事项的战略规划和界定。本报告提供的肾移植数据显示，马其顿、摩尔多瓦、波斯尼亚和黑塞哥维那、罗马尼亚和黑山在4年期间移植活动显著增加。捐赠和移植项目的成功受到关键专业人员的参与以及通过实施适当的资金模式建立组织基础设施的影响。总之，DOI为东南欧国家卫生专业人员的参与提供了一个伦理框架。新成立的SEEHN RHDC作为一个技术协调机构，在建设机构能力以及加强这些国家卫生当局和专业人员之间的区域合作以改善巴尔干地区的移植活动方面做出了巨大贡献。
