vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2020-1-174-183vtio-1158Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSГлобальный дефицит донорских органов: анализ национальных стратегий самообеспеченияGlobal organ shortage: an analysis of national self‑sufficiency strategiesРезникО. Н.ReznikO. N.

Резник Олег Николаевич. 

192242, Санкт-Петербург. ул. Будапештская, д. 3.

Reznik Oleg Nikolaevich. 

3, Budapeshtskaya str., St. Petersburg, 192242

onreznik@gmail.comМихельД. В.MikhelD. V.

Москва

Moscow

ГБУ «Санкт-Петербургский научно-исследовательский институт скорой помощи имени И.И. Джанелидзе»; ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет имени И.П. Павлова»РоссияI.I. Dzhanelidze St. Petersburg Research Institute of Emergency Care; I.P. Pavlov First St. Petersburg State Medical UniversityRussian FederationФГБОУ ВО «Российская академия народного хозяйства и государственной службы при Президенте Российской Федерации»РоссияRussian Presidential Academy of National Economy and Public AdministrationRussian Federation202022042020221174183Copyright © Резник О.Н., Михель Д.В., 20202020Резник О.Н., Михель Д.В.Reznik O.N., Mikhel D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/1158

С позиций социально-гуманитарного знания в статье анализируется проблема глобального дефицита донорских органов. Рассматриваются основные представления международного медицинского сообщества о дефиците органов и основные предложения по его преодолению. Особое внимание уделяется трем наиболее показательным национальным стратегиям самообеспечения донорскими органами – американской, испанской и иранской. Обсуждается вопрос о влиянии культурных различий и фактора социально- экономического неравенства на сложившиеся практики донорства органов на примере Мексики, Турции, Пакистана и Бангладеш.

From the standpoint of socio-humanitarian knowledge, the paper analyzes the problem of global organ shortage. The basic ideas of the international medical community about organ shortage and the main proposals for overcoming it are considered. Special emphasis is placed on the three most revealing national self-sufficiency strategies adopted by donor agencies – American, Spanish and Iranian strategies. The issue of influence of cultural differences and socio-economic inequality on established organ donation practices is discussed using Mexico, Turkey, Pakistan and Bangladesh as examples.

дефицит донорских органовВОЗнациональные стратегии самообеспеченияСШАИспанияИранМексикаТурцияПакистанБангладешorgan shortageWHOnational self-sufficiency strategiesUSASpainIranMexicoTurkeyPakistanBangladeshReferencesWorld Health Assembly Resolution 40.13. Development of guiding principles for human organ transplants, 4–15 May 1987. [Online]. Available: http://apps.who.int/medicinedocs/documents/s15559e/s15559e.pdf (Accessed: 14.08.2019).World Health Assembly Resolution 40.13. Development of guiding principles for human organ transplants, 4–15 May 1987. [Online]. Available: http://apps.who.int/medicinedocs/documents/s15559e/s15559e.pdf (Accessed: 14.08.2019).World Health Assembly Resolution 44.25. Human organ transplantation, 6–16 May 1991. [Online]. Available: http://apps.who.int/medicinedocs/documents/s15559e/s15559e.pdf (Accessed: 14.08.2019).World Health Assembly Resolution 44.25. Human organ transplantation, 6–16 May 1991. [Online]. Available: http://apps.who.int/medicinedocs/documents/s15559e/s15559e.pdf (Accessed: 14.08.2019).Capron A. 1991 Guiding principles: roots and implications. Ethics. Access and safety in tissue and organ transplantation: issues of global concern. Madrid, Spain, 6–9 October 2003. Report. Geneva: WHO, 2004: 9. [Online]. Available: http://www.who.int/transplantation/en/Madrid_Report.pdf?ua=1 (Accessed: 14.08.2019).Capron A. 1991 Guiding principles: roots and implications. Ethics. Access and safety in tissue and organ transplantation: issues of global concern. Madrid, Spain, 6–9 October 2003. Report. Geneva: WHO, 2004: 9. [Online]. Available: http://www.who.int/transplantation/en/Madrid_Report.pdf?ua=1 (Accessed: 14.08.2019).World Health Assembly Resolution 57.18. Human organ and tissue transplantation, 22 May 2004. [Online]. Available: http://www.who.int/gb/ebwha/pdf_files/WHA57/A57_R18-en.pdf. (Accessed: 1.08.2019).World Health Assembly Resolution 57.18. Human organ and tissue transplantation, 22 May 2004. [Online]. Available: http://www.who.int/gb/ebwha/pdf_files/WHA57/A57_R18-en.pdf. (Accessed: 1.08.2019).WHO proposes global agenda on transplantation. WHO. Media centre. 30 March 2007. [Online]. Available: https://www.who.int/mediacentre/news/releases/2007/pr12/en/(Accessed: 1.08.2019).WHO proposes global agenda on transplantation. WHO. Media centre. 30 March 2007. [Online]. Available: https://www.who.int/mediacentre/news/releases/2007/pr12/en/(Accessed: 1.08.2019).The declaration of Istanbul on organ trafficking and transplant tourism (2008 edition). [Online]. Available: https://www.declarationofistanbul.org/images/Policy_Documents/2008_Edition_of_the_Declaration_of_Istanbul_Final.pdf (Accessed: 1.08.2019).The declaration of Istanbul on organ trafficking and transplant tourism (2008 edition). [Online]. Available: https://www.declarationofistanbul.org/images/Policy_Documents/2008_Edition_of_the_Declaration_of_Istanbul_ Final.pdf (Accessed: 1.08.2019).World Health Assembly Resolution 63.22, WHO guiding principles on human cell, tissue and organ transplantation, 21 May 2010. [Online]. Available: https://www.who.int/transplantation/Guiding_PrinciplesTransplantation_ WHA63.22en.pdf (Accessed: 1.08.2019).World Health Assembly Resolution 63.22, WHO guiding principles on human cell, tissue and organ transplantation, 21 May 2010. [Online]. Available: https://www.who.int/transplantation/Guiding_PrinciplesTransplantation_WHA63.22en.pdf (Accessed: 1.08.2019).Delmonico FL, Dominguez-Gil B, Matesanz R, Noel L. A call for government accountability to achieve national self-sufficiency in organ donation and transplantation. Lancet. 2011; 378: 1414–1418.Delmonico FL, Dominguez-Gil B, Matesanz R, Noel L. A call for government accountability to achieve national self-sufficiency in organ donation and transplantation. Lancet. 2011; 378: 1414–1418.Mone TD. The business of organ procurement. Current opinion of organ transplantation. 2002; 7: 60–64.Mone TD. The business of organ procurement. Current opinion of organ transplantation. 2002; 7: 60–64.Our OPOs: New England organ bank. New England donor services: organ and tissue donation. [Online]. Available: https://neds.org/our-opos/ (Accessed: 26.08.2019).Our OPOs: New England organ bank. New England donor services: organ and tissue donation. [Online]. Available: https://neds.org/our-opos/ (Accessed: 26.08.2019).Fox RC, Swazey JP. Spare parts: organ replacement in American society. Oxford, 1992: 3–30.Fox RC, Swazey JP. Spare parts: organ replacement in American society. Oxford, 1992: 3–30.Kaserman DL, Barnett AH. The US organ procurement system: a prescription for reform. Washington, DC, 2002: 8, 12, 13.Kaserman DL, Barnett AH. The US organ procurement system: a prescription for reform. Washington, DC, 2002: 8, 12, 13.Schulak JA, Bohnengel A, Hanto DW et al. The Ohio solid transplantation consortium: a 15-year experience. Transplantation review. 1999; 13 (3): 135–147.Schulak JA, Bohnengel A, Hanto DW et al. The Ohio solid transplantation consortium: a 15-year experience. Transplantation review. 1999; 13 (3): 135–147.Adams PL, Cohen DJ, Danovitch GM et al. The nondirected live-kidney donor: ethical considerations and practice guidelines. Transplantation. 2002; 74 (4): 582– 590.Adams PL, Cohen DJ, Danovitch GM et al. The nondirected live-kidney donor: ethical considerations and practice guidelines. Transplantation. 2002; 74 (4): 582– 590.Henderson AJZ, Landolt MA, McDonald MF et al. The living anonymous kidney donor: lunatic or saint? American journal of transplantation. 2003; 3:203–213.Henderson AJZ, Landolt MA, McDonald MF et al. The living anonymous kidney donor: lunatic or saint? American journal of transplantation. 2003; 3:203–213.Salim A et al. Aggressive organ donor management significantly increases the number of organs available for transplantation. Journal of trauma. 2005; 58 (5): 991– 994.Salim A et al. Aggressive organ donor management significantly increases the number of organs available for transplantation. Journal of trauma. 2005; 58 (5): 991– 994.Matesanz R, Dominguez-Gil B, Coll E et al. How Spain Reached 40 deceased organ donors per million population. American journal of transplantation. 2017; 20: 1–8.Matesanz R, Dominguez-Gil B, Coll E et al. How Spain Reached 40 deceased organ donors per million population. American journal of transplantation. 2017; 20: 1–8.Newsletter transplant. International figures on donation and transplantation 2017. Strasbourg, 2018; 23.Newsletter transplant. International figures on donation and transplantation 2017. Strasbourg, 2018; 23.Gracia D. Prior consent of deceased and family permission. Ethics. Access and safety in tissue and organ transplantation: issues of global concern. Madrid, Spain, 6–9 October 2003. Report. Geneva: WHO, 2004: 10–11.Gracia D. Prior consent of deceased and family permission. Ethics. Access and safety in tissue and organ transplantation: issues of global concern. Madrid, Spain, 6–9 October 2003. Report. Geneva: WHO, 2004: 10–11.Jahromi AH, Fry-Revere S, Bastani B. A revised Iranian model of organ donation as an answer to the current organ shortage crisis. Iranian journal of kidney diseases. 2015; 9 (5): 354–360.Jahromi AH, Fry-Revere S, Bastani B. A revised Iranian model of organ donation as an answer to the current organ shortage crisis. Iranian journal of kidney diseases. 2015; 9 (5): 354–360.Ghods AJ. The history of organ donation and transplantation in Iran. Experimental and clinical transplantation. 2014; 12 (1) Supplement: 38–41.Ghods AJ. The history of organ donation and transplantation in Iran. Experimental and clinical transplantation. 2014; 12 (1) Supplement: 38–41.Zargooshi J. Iranian kidney donors: motivations and relations with recipients. Journal of urology. 2001; 165 (2): 386–392.Zargooshi J. Iranian kidney donors: motivations and relations with recipients. Journal of urology. 2001; 165 (2): 386–392.Zargooshi J. Quality of life Iranian kidney «donors». Journal of urology. 2001; 166 (5): 1790–1799.Zargooshi J. Quality of life Iranian kidney «donors». Journal of urology. 2001; 166 (5): 1790–1799.Ghods AJ, Savaj S. Iranian model of paid and regulated living-unrelated kidney donation. Clinical Journal of the American Society of Nephrology. 2006; 1 (6): 1136–1145.Ghods AJ, Savaj S. Iranian model of paid and regulated living-unrelated kidney donation. Clinical Journal of the American Society of Nephrology. 2006; 1 (6): 1136–1145.Mahdavi-Mazdeh M. The Iranian model of living renal transplantation. Kidney international. 2012; 82: 627– 634.Mahdavi-Mazdeh M. The Iranian model of living renal transplantation. Kidney international. 2012; 82: 627– 634.Groth C-G. Global activity and developments in organ transplantation. Ethics. access and safety in tissue and organ transplantation: issues of global concern. Madrid, Spain, 6–9 October 2003. Report. Geneva: WHO, 2004: 6. [Online]. Available: http://www.who.int/transplantation/en/Madrid_Report.pdf?ua=1 (Accessed: 14.08.2019).Groth C-G. Global activity and developments in organ transplantation. Ethics. access and safety in tissue and organ transplantation: issues of global concern. Madrid, Spain, 6–9 October 2003. Report. Geneva: WHO, 2004: 6. [Online]. Available: http://www.who.int/transplantation/en/Madrid_Report.pdf?ua=1 (Accessed: 14.08.2019).Moazam F. Paucity of Cadaveric Kidneys: A Sociocultural Issue. Ethics. access and safety in tissue and organ transplantation: issues of global concern. Madrid, Spain, 6–9 October 2003. Report. Geneva: WHO, 2004: 12. [Online]. Available: http://www.who.int/transplantation/en/Madrid_Report.pdf?ua=1 (Accessed: 14.08.2019).Moazam F. Paucity of Cadaveric Kidneys: A Sociocultural Issue. Ethics. access and safety in tissue and organ transplantation: issues of global concern. Madrid, Spain, 6–9 October 2003. Report. Geneva: WHO, 2004: 12. [Online]. Available: http://www.who.int/transplantation/en/Madrid_Report.pdf?ua=1 (Accessed: 14.08.2019).Crowley-Matoka M. Domesticating organ transplant: familial sacrifice and national aspiration in Mexico. Durham: Duke university press, 2016.Crowley-Matoka M. Domesticating organ transplant: familial sacrifice and national aspiration in Mexico. Durham: Duke university press, 2016.Crowley-Matoka M, Lock M. Organ transplantation in a globalized world. Mortality: promoting the interdisciplinary study of death and dying. 2006; 11 (2): 172.Crowley-Matoka M, Lock M. Organ transplantation in a globalized world. Mortality: promoting the interdisciplinary study of death and dying. 2006; 11 (2): 172.Sanal A. «Robin Hood» of techno-turkey or organ trafficking in the state of ethical beings. Culture, medicine, and psychiatry. 2004; 28: 281–309.Sanal A. «Robin Hood» of techno-turkey or organ trafficking in the state of ethical beings. Culture, medicine, and psychiatry. 2004; 28: 281–309.Karakayali H, Haberal M. The history and activities of transplantation in Turkey. Transplantation proceedings. 2005; 37: 2905–2908.Karakayali H, Haberal M. The history and activities of transplantation in Turkey. Transplantation proceedings. 2005; 37: 2905–2908.Moazam F. Bioethics and organ transplantation in a Muslim society: a study in culture, ethnography, and religion. Bloomington: Indiana University Press, 2006.Moazam F. Bioethics and organ transplantation in a Muslim society: a study in culture, ethnography, and religion. Bloomington: Indiana University Press, 2006.Moazam F, Moazam Zaman R, Jafarey AM. Conversations with kidney vendors in Pakistan. Hastings center report. 2009; 39 (3): 29–44.Moazam F, Moazam Zaman R, Jafarey AM. Conversations with kidney vendors in Pakistan. Hastings center report. 2009; 39 (3): 29–44.Moazam F, Jafarey AM. Pakistan’s experience with kidney transplantation and trade: a call for international solidarity. Indian journal of medical ethics. 2014; 11 (3): 156–162.Moazam F, Jafarey AM. Pakistan’s experience with kidney transplantation and trade: a call for international solidarity. Indian journal of medical ethics. 2014; 11 (3): 156–162.Cohen L. Where it hurts: Indian material for an ethics of organ transplantation. Daedalus. 1999; 128 (4): 156.Cohen L. Where it hurts: Indian material for an ethics of organ transplantation. Daedalus. 1999; 128 (4): 156.Moniruzzaman M. Living cadavers in Bangladesh: bioviolence in the human organ bazaar. Medical anthropology quarterly. 2012; 26 (1): 69–91.Moniruzzaman M. Living cadavers in Bangladesh: bioviolence in the human organ bazaar. Medical anthropology quarterly. 2012; 26 (1): 69–91.Moniruzzaman M. Domestic organ trafficking: between biosecurity and bioviolence. Bioinsecurity and vulnerability, eds. Chen N., Sharp L. Santa Fe, NM: School of advanced research press, 2014: 195–215.Moniruzzaman M. Domestic organ trafficking: between biosecurity and bioviolence. Bioinsecurity and vulnerability, eds. Chen N., Sharp L. Santa Fe, NM: School of advanced research press, 2014: 195–215.Scheper-Hughes N. Theft of life: the globalization of organ stealing rumours. Anthropology today. 1996; 12 (3): 3–11. 39. Scheper-Hughes N. The global traffic in human organs. Current anthropology. 2000; 41 (2): 191–224.Scheper-Hughes N. Theft of life: the globalization of organ stealing rumours. Anthropology today. 1996; 12 (3): 3–11. 39. Scheper-Hughes N. The global traffic in human organs. Current anthropology. 2000; 41 (2): 191–224.

The authors declare that there are no conflicts of interest present.