On the 2nd of April, 2008, liver transplantation operation was performed for the first time in Belarus at Minsk Clinical hospital №9 (O.O.Rummo). This operation was a result of well-coordinated work of different specialists who had undergone training at clinics of Germany and Russia. In 2008 there were 11 of such operations, in 2009 - 22, in 2010 - 35, in 2011 - 43, in 2013 - 66, in 2015 - 68, in 2015 - 72. In 2009 there was the first pancreas gland transplantation performed at Minsk City Clinical Hospital №9. In 2010 the Republican Scientific and Practical Center of Organ Transplantation was founded and started functioning on the basis Minsk City Clinical Hospital №9. Since 2009 the coordination division of harvesting for transplantation has been coordinating all donor issues, and is situated at Minsk City Clinical Hospital №9. It was founded in 2005 on the basis of Minsk City Clinical Hospital №4.
Such an intensive development of transplantology demanded organization of special training for physicians. In 2009 a new training course on transplantology was created at the Department of Cardiosurgery at Belarusian Medical Academy of Post-Graduate Education. The course was taught by the following teaching staff: A.M.Fedoruk, O.O.Rummo, A.E.Scherba, Y.V.Slobodin, S.V.Korotkov, A.M.Dziadko, L.S.Bolonkin, O.S.Bogushevich, A.N.Danilenko, L.A.Zernova, T.V.Lisyanovich. I.I.Pikirenya, an Associate Professor, was head of the course.
Within the period from 2009 to 2012 the course of advanced training and retraining was undergone by 509 physicians, 49% of them were surgeons, 30% - intensivists, 9% - urologists and nephrologists, 6% - ultrasonic medical investigation specialists. A lecture room with a translation from an operating room is used during the classes. Experience has shown that advanced training courses on transplantology are in demand among Belarusian physicians. The plan of physicians' preparation has been completed by 125 %. As the need for transplantation medical care has increased in Belarus, the number of physicians who need to undergo advanced training on transplantology is constantly growing, not only surgeons undergo training, but also intensivists, nephrologists, urologists, ultrasonic medical investigation specialists, public health administrators (head doctor assistants, heads of departments), neurologists and neurosurgeons. Demand in advanced training courses is connected with the fact that the courses deal, along with transplantation issues and legal aspects of transplantation, also anesthesia services issues at large operations on abdominal cavity organs and transplantation, perioperative preparation, side issues of intensive therapy, issues of ultrasound diagnostics and minimally invasive surgery, transplantation technologies in liver surgery are widely covered.
Thus, the course on transplantology needed to be reorganized into the Department of Transplantology. In accordance with the rector's Order (decision of Rectorate and Council of BelMAPO), as agreed upon with the Ministry of Health of the Republic of Belarus, from January, 2013, a new Department of Transplantology was founded by the Academy with a clinical base at the Republican Scientific and Practical Center for Organ and Tissue Transplantation (Minsk City Clinical Hospital).
The clinical base of the Department has all needed conditions for the application of modern examination methods at the pathology of hepatobiliary system, including terminal stages of liver, kidneys, pancreatic gland diseases. All kinds of operative interventions are performed on hepatobiliary system, including organ transplantation (liver, pancreatic gland, kidneys, lungs, heart).
Staff of the Department is represented by highly qualified specialists of the Republican Scientific and Practical Center for Organ and Tissue Transplantation, based on Minsk City Clinical Hospital №9. Staff of the Department participates in complicated and high tech operative interventions on organs of abdominal and thoracic cavities, including all kinds of liver, kidneys, pancreatic gland transplantations, in preparation of anaesthetic support at such interventions and also intensive therapy.
Staff of the Department mastered and implemented the most complicated, high tech and exclusive interventions and methods into practice:
- Liver and kidney transplantation in adults and children
- Pancreatic gland transplantation
- Transplantation of pancreatic gland and liver
- Lung transplantation
- Liver resection (hernihepatectomy, extended hernihepatectomies, sectorectomies, segment resections, nonanatomic liver resections), endovascular embolization, chemoembolization of hepatic tumors, two-stage liver resection, TIPS.
- Liver resection with vessel resection and total/selective vessel isolation at extended liver resections.
- Angioplasty and stenting of vessels of hepatobiliary area, brain, limb vessels.
- Operations on pancreatic gland (Frey operation, Beger operation, Bernese variant of Beger operation, laparoscopic proximal and distal resections of pancreatic gland).
- Laparoscopic resections of lien, and laparoscopic sampling of donor kidney.
- Segmentectomy, atypical resection of lung, upper, middle and lower lobectomy, bilobectomy, upper, middle, lower lobectomy with circumferential or cuneal resection of bronchi and/or lung artery, pneumonectomy.
- trachea sleeve resection.
- combined lung resection or pneumonectomy with resection of descending thoracic aorta with prosthetics;
- combined resection of lung or pneumonectomy with resection of upper cava (acentric, fenestrate, circumferential with prosthetics)
- Combined resection of lung or pneumonectomy with resection of left and right atrium (if needed - in conditions of extracorporeal circulation);
- combined resection of lung with chest wall resection, also in case of superior sulcus tumor;
- pneumonectomy with cuneal or sleeve resection of tracheal bifurcation;
- douchebagary thoracoscopy, biopsy of pleura mass, lung, intrathoracic lymph nodes;
- single-plane operations on respiratory organs, heart and magistral arteries at concurrent cardiovascular pathology and respiratory organ diseases;
- amplitude reducing resections of lung at bullous lung transformation at Chronic Obstructive Lung Diseases
- mediastinal oncotomy with resection of respiratory tracts, great vessels - of upper cava, brachiocephalic veins, aortic arch and its branches.
Advanced training courses are organized for physicians of different specialties (for chief operating officers, heads of departments, organ transplant surgeons, surgeons, intensivists, neurologists, neurosurgeons, nephrologists, urologists, ultrasonic medical investigation specialists, gastroenterologists).
- Transplantation coordination and organ donation
- Liver transplantation
- Transplantation technologies in liver surgery
- Kidney transplantation
- Transplantation technologies in thoracic surgery
- Intensive therapy and anesthesia service of organ transplantations and highly traumatic operations on organs of abdominal cavity
- Transplantation technologies in intensive therapy of patients with surgical disorders
- Minimally invasive liver surgery and pancreatic gland surgery with ultrasound diagnostics
Achievements of the Department of Transplantology
Since 2009 the staff of the Department prepared all needed documentation for the teaching, lecture material and guidance papers of practical classes.
From 2009 to 2012 the course of transplantology had been undergone by 509 physicians.
From 2013 to 2015 the Department of Transplantology prepared 580 doctors (456 - according to the plan)
Staff of the Department participates in complicated and high tech surgery interventions on abdominal and thoracic cavity organs, including all kinds of liver, kidney, pancreatic gland transplantations, in provision of anaesthetic support at such interventions, and also intensive therapy. Staff of the Department mastered and implemented the most complicated, high tech and exclusive interventions and methods into the practice: liver and kidney transplantation to children and adults, transplantation of pancreatic gland, transplantation of the complex pancreatic gland and kidney, two-stage resection of liver, total and selective vessel isolation at extended liver resections, laparoscopic interventions - splenectomy, anteperitone alhernioplasty, donor kidney sampling etc.).
Since 2009 there have been a lot of publications: 2 monographs, practice guidelines for doctors, 5 guidance manuals, 35 articles (3 of them - in foreign publications, 55 theses. I.I.Pikirenya is a member of editorial board of scientific and practical magazine "News of Surgery", I.I.Pikirenya and O.O.Rummo are members of editorial board of international scientific and practical magazine "Surgery. Eastern Europe".
Staff of the Department are members of numerous international organizations, the main visiting specialists of the Ministry of Health of the Republic of Belarus, members of associations of surgeons.
7 members of the Department have undergone advanced training courses in Germany, Sweden, England, Russia, USA. The staff participates in international conferences - more than in 60 conferences for the period of 4 years.
In 2012 four times our specialists went to Kazakhstan with master-classes on endovideosurgical kidney sampling for transplantation, kidney transplantation, minimally invasive surgery (O.O.Rummo, O.V.Kalachik, A.E.Scherba, A.M.Fedoruk, Y.V.Slobodin).