Perspectives of donation and transplantation in Central Eastern Europe

As a result of the profound political changes in the years 1989-90 the physically and psychologically closed borders among eastern countries as well as between western and eastern countries were opened. This resulted in free communication among transplant professionals and a new type of collaboration starred among transplantation teams. Most of Central-Eastern European (CEE) countries started with a kidney transplantation program as early as in the West-European countries. In the CEE coun tries the transplantation activity was lower compared to the West-European countries, mainly clue to financial difficulties, the small number of recipients on the waiting list (insufficient dialysis supply) and lack of political support. We sent a questionnaire to the key persons of transplantation of nine EEC coun fries. Six of them sent back the answers which were evaluated and summarized. In some countries the kidney transplantation program started as early as in the western part of Europe (1962-1967). The liver and heart program started 10-15 years later than in Western Europe. All transplant organizations (if exists) are ''national'' and governmental, are controlled generally by the Ministry of Health. The transplant legislation is solved in most of these countries. The ''presumed consent'' is accepted except Lithuania. The proportion of multiorgan donors (MOD) is very poor in all countries, ex: cept Poland. While the demand of extrarenal organs would be high, a great part oi donor organs are not used. This one of the reasons of small proportion of multiorgan donation. The total number of kidney transplantations in 5 years is about 1000 in three countries (Czech Republic, Hungary and Poland) and very few in the other countries. The conclusions are: 1. In the CEE countries there are much more donors, then used actually. 2. If the small countries manage their transplant programmes by themselves then they have the following difficulties: regarding the kidney programme the likelihood oi a good HLA match will be low, regarding the liver and heart programme they will not have an appropriate donor in case of urgent transplantation or in case of fulminant hepatitis.