Organ and tissue transplantation is a treatment method aimed at restoring certain functions of the human body by the transfer of a part of the donor’s body into the body of the recipient. The process of transplantation is inseparably linked with the process of organ donation, where the donor, while still alive or after death, donates a body part for the purpose of transplantation. The person who receives a part of the donor’s body for therapeutic purposes is called the recipient. Organ and tissue donation is possible only with the prior consent to donation, given by the donor signing the donor statement while still alive, or by the donor’s family consenting to donation after the donor’s death.

Donation and transplantation of organs, tissues and cells is founded on the principles of voluntary and unpaid donation, altruism, professionalism, efficiency, ethics, and transparency.

In Slovenia, it is possible to donate the following organs: heart, lungs, liver, kidneys and pancreas. Tissues and cells that can be donated include corneas, skin, bones, cartilage, tendons, ligaments, haematopoietic stem cells, blood cells, heart valves, and vessels.

Modern medicine accepts brain death, defined as the final and irreversible cessation of function of the entire brain (both hemispheres and the brainstem), as the death of an individual. The functioning of the cardiovascular and respiratory systems in a brain-dead patient can be artificially maintained. Brain death occurs as a consequence of the cessation of blood flow through the brain or prolonged shortage of oxygen supply to the brain. The most frequent causes of brain death are cerebral haemorrhage, serious brain injury, stroke, malignant intracranial tumours, and ischaemic brain damage.

The method of determining brain death is laid down by a special regulation, which defines the medical criteria, procedure, structure of the appropriate commission, and the clinical tests that must be performed to establish the diagnosis. For the definitive diagnosis, an ancillary investigation is usually required to demonstrate the cessation of intracranial blood flow (EEG, perfusion scintigraphy, CT angiography, transcranial US).

Organ donation after brain death can take place only once brain death has been unequivocally demonstrated. For organ and tissue donation after death, prior consent must be obtained in a legally prescribed form from either the donor while still alive, or from the donor’s family after the donor’s confirmed brain death. Organ retrieval surgery is conducted as a surgical procedure for which the same requirements must be fulfilled as for any other operation. The only visible mark after organ donation is the surgical incision. The entire donation process is carried out with respect, safeguarding the dignity of the donor and the family of the deceased.

Living donation is defined as donation to a person with whom the donor is genetically or emotionally related. The risk to the donor’s health must remain within medically acceptable limits. To prevent abuse, each case of living donation is considered separately by the Transplant Ethics Committee.

The only organs that can be donated during lifetime are a kidney, a lung, and parts of the liver, pancreas and bowel. The tissues and cells that can be donated while alive include skin, blood, and haematopoietic stem cells (bone marrow).

Schematic presentation of organ donation and transplantation

Shematski prikaz

History of transplantation activities in Slovenia