Giving life after death: everything you need to know about posthumous transplantation in Ukraine

Why is it important to become a donor? Where can you find a transplant coordinator and application samples? Can you change your decision, and what to tell your relatives? Rubryka gathered the answers.

The war continues, and the number of human casualties on the front and among the civilian population is increasing daily. Now more than ever, it's crucial to recognize that our lives can end anytime. The war once again emphasized the need for transplantation development in Ukraine. After death, you can save someone's life. How exactly do you do that? We explain.

Two years ago, actor Andrii Panas died tragically due to a fall. The artist received cerebral edema, which led to his death. His wife consented to organ harvesting, and the organs were transplanted into four people. Among the rescued is a three-year-old girl.

2023 was the third year of Ukraine's pilot project on organ transplantation. As part of the project, domestic doctors performed 384 organ transplants in 2022 alone, more than half of them from a deceased donor. This means that every Ukrainian can consent to posthumous organ transplantation, thereby saving someone's life after death.

Currently, 26 transplant centers are already operating in Ukraine. In one of them at the Kyiv Regional Clinical Hospital, 41 surgeries were performed in the last six months alone.

Andrii Panas's case also inspired a Ukrainian journalist and co-anchor of Television Toronto, Yaroslava Kravchenko, who decided to consent to posthumous organ donation. Using her example, the presenter showed that the procedure is simple, transparent, and understandable.

There are two ways to become a donor of anatomical materials after death.

The first way is to write a written statement (application sample at the link) and submit it to the transplant coordinator of any transplant center. 

• Only an adult with legal capacity can do it. 
• A list of transplant centers in all regions can be found at the link.

Based on the application, the system will create a corresponding card in the Unified State Information System for Transplantation of Organs and Tissues (YEDIST). A scanned copy of the application will be attached to this card. No medical worker can see information from the YEDIST card until the brain of the person who submitted such a statement is dead.

Ukraine's Ministry of Health has just announced the second way. Minister of Health Viktor Liashko reported that the opportunity to give consent or disagreement to posthumous transplantation would soon appear in the Diia public service portal. This method can solve many bureaucratic problems and facilitate the consent process, especially for those Ukrainians living in the regions.

Some Ukrainians who wish to become posthumous donors note that finding a transplant coordinator in the region is complex. For example, in the areas marked in dark blue on the map below, there is no transplant coordination center.

If you are facing this problem, try to write to the Facebook page of the Ukrainian Transplant Coordination Center to get the contact of a coordinator who can help.

If consent or non-consent for posthumous donation was not given by the deceased during their lifetime, it could be provided by relatives.

If, for one reason or another, you did not sign the application for YEDIST. You can talk to those closest to you and share your thoughts about being ready to become a donor after death. Such foresight can make it easier for them to decide when the need arises.

But there may be difficulties here. Natalia Shchukina, the lawyer of the Dejure legal consulting company, brings attention to the fact that relatives cannot always make the right decision:

"This situation is challenging psychologically because people losing a loved one are not always ready to consider the possibility of donation. Sometimes they cannot answer to themselves whether the deceased would've wanted it. A person's expressed recorded will during their lifetime removes these questions and, in the case of consent, makes it possible not to lose precious time and save the lives of those who need a donor organ transplant."

The lawyer believes that if a person is firmly convinced to become a posthumous donor, they should sign the application during their lifetime. The opportunity to do it through the Diia app will only facilitate the entire process.

Suppose a person doesn't want their organs to be used as a donor after their death. In that case, they can also write and submit a statement of disagreement to the transplant coordinator (statement sample here) for post-mortem donation, and based on this application, the system will also create a card in YEDIST.

In the event of the application's owner's death, none of the relatives will be able to change the decision.

During life, a person can repeatedly change their decision about consent or disagreement, which in turn cancels their previous statement. Reversing the decision regarding posthumous donation occurs similarly by contacting the transplant coordinator (application sample for withdrawal of consent here).

Donors of organs and anatomical materials cannot be:

• orphans and children deprived of parental care;
• people recognized as incapable;
• those whose identity is unknown;
• military personnel having died during hostilities and civilians injured as a result of shelling.