SHORTAGE OF DONOR ORGANS: REASONS, PROBLEMS, wAYS OF SOLUTION
Shortage of donor organs is a major constraint to the development of transplantology, its reasons require close investigation. To obtain donor organs is a difficult medical activity and depends on the efforts, motivation, and scholarship of physicians of different specialties. The paper describes the primary results of analysis of the main indicators of organ donation in Saint Petersburg in 2006 to 2009; an attempt was made to determine the basic concepts and criteria for the efficiency of the work of donor hospitals and to develop an audit algorithm for deaths from brain injuries and cerebral circulatory disorders at donor hospitals. Better organization of care to brain injury victims is shown to lead not only to mortality reduction and to a rise in the detection rate of effective donors. It has been ascertained that the basic reserve to expand the donor pool should be sought among patients with cerebrovascular diseases. It is essential not only to change organizational approaches to treating such victims, but also to do work to increase neurologists awareness of the diagnosis of brain death and to explain to them the legality of their participation in donor programs. The paper provides the results of scientific substantiation and the necessity of identifying donation work done by the hospital as an individual type of medical services, as well as their medicoeconomic analysis and a rationale for refinancing in the context of state guarantees for high-tech care by donor organ transplantation.