natgillin/translations-raw huggingface dataset:
G. ker je izmenjava organov med državami članicami že stalna praksa, čeprav se število čezmejno izmenjanih organov med državami članicami zelo razlikuje, mednarodne organizacije za izmenjavo organov, na primer Eurotransplant in Scandiatransplant, pa so omogočile, da so take izmenjave organov med državami članicami lažje,
G. whereas the exchange of organs between Member States is already common practice, although there are wide differences in the number of organs exchanged across borders between Member States; and whereas the exchange of organs between Member States has been facilitated by international exchange organisations such as Eurotransplant and Scandiatransplant,
H. ker v Evropski uniji ni skupne baze podatkov o organih, ki so namenjeni darovanju in presaditvi, ter o živih ali umrlih darovalcih, prav tako pa ni vseevropskega sistema certificiranja, ki bi zagotavljal, da je bilo človeško telesno tkivo pridobljeno zakonito,
H. whereas at present there is neither a database covering the whole of the European Union which contains information about organs intended for donation and transplantation or on living or deceased donors, nor, moreover, a pan-European certification system which provides proof that human organs and tissues have been legally obtained,
I. ker so do sedaj le Španija in nekatere druge države članice uspele bistveno povečati število organov umrlih darovalcev in ker je dokazano, da so takšna povečanja povezana z uvedbo nekaterih organizacijskih praks, ki sistemom omogočajo odkriti morebitne darovalce in kar najbolj povečati število darovalcev, ki po smrti dejansko darujejo organ,
I. whereas only Spain and few other Member States have succeeded in increasing significantly the number of deceased donations, and it has been proven that such increases are linked to the introduction of certain organisational practices that allow the systems to identify potential donors and maximise the number of deceased persons becoming actual donors,
J. ker bo Direktiva 2004/23/ES zagotovila jasen pravni okvir za darovanje in presajanje organov v Evropski uniji, v vsaki državi članici pa bo ustanovljen ali določen nacionalni pristojni organ za zagotavljanje skladnosti s kakovostnimi in varnostnimi standardi EU,
J. whereas Directive 2004/23/EC will provide a clear legal framework for organ donation and transplantation in the European Union, with the result that in every Member State a national competent authority will be created or designated to ensure compliance with EU quality and safety standards,
K. ker je trgovanje s človeškimi organi in ljudmi z namenom odvzema njihovih organov huda kršitev človekovih pravic,
K. whereas the trafficking of organs and of human beings for the purpose of removing organs constitutes a severe violation of human rights,
L. ker obstaja močna povezava med nezakonito trgovino z organi in trgovino z ljudmi z namenom odvzema organov na eni ter zakonitim sistemom darovanja organov na drugi strani, saj prvič nezadostna razpoložljivost organov v zakonitem sistemu spodbuja nezakonita dejanja, drugič pa nezakonite dejavnosti resno spodkopavajo verodostojnost zakonitega sistema darovanja organov,
L. whereas there is a strong link between illegal organ trafficking and the trafficking of persons for the purpose of removing organs on the one hand and the legal system of organ donation on the other because, firstly, the non-availability of organs in the legal system acts as an incentive for illegal activities, and, secondly, illegal activities severely undermine the credibility of the legal system of organ donation,
M. ker se delež zavrnjenih darovanih organov po Evropi močno razlikuje, takšne razlike pa je mogoče pojasniti s stopnjo usposobljenosti in strokovnosti delavcev pri komunikaciji in družinski oskrbi, različnimi zakonodajnimi pristopi na področju privolitve v darovanje organov in njihovim praktičnim izvajanjem ter ostalimi pomembnimi kulturnimi, ekonomskimi ali socialnimi dejavniki, ki vplivajo na družbeno dojemanje koristi darovanja in presajanja,
M. whereas rates of refusal of organ donation vary widely within Europe, and such variability could be explained by the level of training and expertise of professionals in terms of communication and family care, the different legislative approaches to consent to organ donation and their practical implementation, and other important cultural, economic or social factors that influence society’s perception of the benefits of donation and transplantation,
N. ker so lahko organi živih darovalcev koristen dodaten ukrep za bolnike, ki s presaditvijo po smrti ne morejo dobiti potrebnega organa, vendar je treba poudariti, da je darovanje organov živih darovalcev sprejemljivo le, če je mogoče izključiti vsakršno nezakonito dejavnost in plačilo za darovanje,
N. whereas living donation can be a helpful additional measure for patients who cannot get the organ they need via post-mortem transplantation, but whereas it needs to be emphasised that living donation can only be considered if any illegal activity and payment for the donation has been ruled out,
O. ker se sme zdravstveni poseg opraviti zgolj po tem, ko je zadevna oseba podala svobodno privolitev po predhodni seznanitvi; ker je treba tej osebi predhodno podati ustrezne informacije o namenu in značaju posega ter o njegovih posledicah in tveganjih, ta oseba pa lahko privolitev kadar koli svobodno umakne,
O. whereas a healthcare intervention may only be carried out after the person concerned has given free and informed consent to it; whereas that person should be given appropriate information beforehand as to the purpose and nature of the intervention as well as on its consequences and risks; and whereas the person concerned may freely withdraw consent at any time,
P. ker morajo države članice zagotoviti, da organi, namenjeni presaditvi, niso odvzeti umrli osebi, dokler njena smrt ni potrjena v skladu z nacionalno zakonodajo,
P. whereas Member States must ensure that organs intended for transplantation are not removed from a deceased person unless that person has been certified dead in accordance with national law,
Q. ker bi moralo darovanje organov živih darovalcev dopolnjevati darovanje organov umrlih darovalcev,
Q. whereas living donation should be complementary to deceased donation,
R. ker pri uporabi organov za zdravljenje obstaja tveganje prenosa nalezljivih in drugih bolezni,
R. whereas the use of organs in therapy entails a risk of transmission of infectious and other diseases,
S. ker je posledica podaljševanja življenjske dobe slabša kakovost organov, kar pogosto pomeni tudi zmanjšanje števila presaditev tkiv, tudi v državah članicah, kjer se število darovalcev povečuje,
S. whereas the fact that people are living longer is serving to reduce the quality of available organs, which in turn is leading in many cases to a reduction in the number of transplants, including in those Member States where the number of donors is increasing,
T. ker imata osveščenost in mnenje javnosti zelo pomembno vlogo pri povečevanju števila darovalcev organov,
T. whereas public awareness and opinion play a very important role in increasing organ donation rates,
U. ker delo dobrodelnih in drugih prostovoljnih organizacij v državah članicah povečuje ozaveščenost o darovanju organov in ker njihovo prizadevanje v končni fazi prispeva k povečanju števila ljudi, ki se vpišejo v registre darovalcev organov,
U. whereas work carried out by charities and other voluntary organisations in Member States increases awareness of organ donation, and whereas their efforts ultimately contribute to an increase in the numbers of people on organ donor registers,
2. izraža zaskrbljenost, ker je razpoložljivih človeških organov za presaditev premalo, da bi zadovoljili potrebe bolnikov; priznava, da je veliko pomanjkanje darovalcev organov še vedno najpomembnejša ovira za popoln razvoj storitev presajanja in glavni izziv, s katerim se v zvezi s presajanjem organov srečujejo države članice EU;
Expresses its concern over the insufficiency of available human organs for transplantation to meet patients´ needs; acknowledges that the severe shortage of organ donors remains a major obstacle preventing the full development of transplant services and the main challenge that the Member States face with regard to organ transplantation;
6. poudarja, da lahko spremembe pri organizaciji darovanja in pridobivanja organov bistveno zvišajo in ohranijo stopnje darovanja organov;
Emphasises that changes to the organisation of organ donation and procurement can substantially increase and sustain organ donation rates;
9. pozdravlja dejavnosti sistemov Eurotransplant in Scanditransplant, vendar opozarja, da je mogoče znatno izboljšati tudi izmenjavo organov zunaj teh sistemov ter med njima, zlasti v korist bolnikov iz manjših držav;
Welcomes the activities of Eurotransplant and Scanditransplant, but notes that exchanges of organs outside these systems and between these systems can be significantly improved, especially for the benefit of patients in small countries;
14. poudarja, da sta oblikovanje dobro strukturiranih operativnih sistemov in spodbujanje uspešnih modelov na nacionalni ravni izredno pomembna; predlaga, naj operativni sistemi vključujejo ustrezen pravni okvir, tehnično in logistično infrastrukturo ter organizacijsko podporo z učinkovitim sistemom dodeljevanja;
Stresses that the establishment of well-structured operational systems and the promotion of successful models at a national level are of the utmost importance; suggests that operational systems should comprise an adequate legal framework, technical and logistic infrastructure, and organisational support coupled with an effective allocation system;
18. nadalje poziva države članice, naj poenostavijo vpisovanje posebnih navedb ali oznak na osebne izkaznice ali vozniška dovoljenja darovalcev, da bi jih lažje prepoznali kot take;
Calls, further, on the Member States to take steps to facilitate the inclusion, on national identity cards or driving licences, of references or symbols which identify the holder as an organ donor;
21. meni, da je treba zagotoviti ustrezno ravnotežje med zaščito anonimnosti in zaupnosti darovalca na eni ter možnostjo sledenja darovanih organov v zdravstvene namene na drugi strani, da bi preprečili nagrajevanje darovanja organov ter trgovino in promet z njimi;
Believes it is necessary to ensure that a suitable balance is struck between, on the one hand, the protection of the donor in terms of anonymity and confidentiality and, on the other hand, the ability to trace organ donations for medical purposes, in order to prevent the remuneration of organ donation and trading and trafficking in organs;
25. ugotavlja, da ni na voljo celostnega sistema za zbiranje podatkov o različnih vrstah presaditev in njihovih rezultatih, čeprav je več držav članic uvedlo obvezno registracijo postopkov presajanja, obstaja pa tudi nekaj prostovoljnih registrov;
Notes that, although several Member States have introduced compulsory registration of transplant procedures and some voluntary registries also exist, no comprehensive system exists to collect data on the different types of transplantation and their outcomes;
Resolucija Evropskega parlamenta z dne 22. aprila 2008 o darovanju in presajanju organov: ukrepi politike na ravni EU (sprejeta besedila tega dne, P6_TA(2008)0130 )) (2007/2210 (INI). , ter meni, da bi jih Komisija morala v celoti upoštevati pri načrtovanju akcijskega načrta; vztraja, da je treba okrepiti ozaveščenost o tej težavi tako v Komisiji kot v Europolu;
European Parliament resolution of 22 April 2008 on organ donation and transplantation: Policy actions at EU level (Texts adopted of that date, P6_TA(2008)0130 )) (2007/2210 (INI). and takes the view that these should be taken fully into account by the Commission when drafting the action plan; insists that awareness of the problem within the Commission and Europol needs to be increased;
35. odločno zavrača vedenje nekaterih zdravstvenih zavarovalnic, ki bolnike spodbujajo k presaditvenemu turizmu, in poziva države članice, naj takšno vedenje strogo nadzorujejo in kaznujejo;
Strongly rejects the behaviour of some health insurance organisations in encouraging patients to participate in transplant tourism and asks the Member States to monitor strictly and punish such behaviour;
Dobitnik Nobelove nagrade Joseph Murray je prvi poročal o uspešni presaditvi ledvice med enojajčnima dvojčkoma, ki jo je opravil leta 1954.
The Nobel Prize winner Joseph Murray was the first to report a successful kidney transplant between identical twins, performed in 1954.
Od takrat je presajanje organov postopoma postalo dobro uveljavljena in izredno pomembna oblika zdravljenja.
Since then, organ transplantation has progressively become a well established therapy of unequivocal importance.
Presaditev ledvice je najboljša oblika zdravljenja za bolnike z odpovedjo ledvic, saj zagotavlja najboljše izide v smislu preživetja, kakovosti življenja in stroškovne učinkovitosti v primerjavi z drugimi oblikami nadomestnega zdravljenja ledvic.
Kidney transplantation represents the best therapeutic option for patients with end stage renal disease, providing best outcomes in terms of survival , quality of life and cost-effectiveness than other renal replacement therapies.
V meta-analitičnem pregledu medicinske in ekonomske literature o nadomestnih oblikah zdravljenja ledvic, objavljene v 20-letnem obdobju, je bilo ugotovljeno, da je postalo presajanje ledvic sčasoma stroškovno učinkovitejše.
In a meta-analytic review of the medical and economical literature evaluating renal replacement therapies, published during a 20 year period, the authors concluded that renal transplantation has become more cost-effective over time.
Presaditve jeter, srca in pljuč so skoraj edina oblika zdravljenja za bolnike z odpovedjo jeter, srca in pljuč, čeprav se presaditev jeter uporablja tudi za zdravljenje nekaterih bolezni, ki sicer ne povzročajo odpovedi jeter.
Liver, heart and lung transplantation represent an almost unique therapeutic alternative for patients with end stage liver, heart and lung failure, although liver transplantation has been also applied for the treatment of specific pathologies not causing end stage liver failure.
S presaditvijo trebušne slinavke v različnih oblikah se pri nekaterih diabetičnih bolnikih ponovno vzpostavi izločanje inzulina, kar bolnikom podaljšuje življenje in dviguje kakovost življenja.
Pancreas transplantation, in its different modalities, has become a solution to re-establish insulin secretion in selected diabetic patients aiming to improve patient survival and quality of life.
Presaditev tankega črevesa, ki se ponavadi opravi skupaj s presaditvijo več organov, je zaenkrat razmeroma redek poseg, a koristen, kadar je bolnik v smrtni nevarnosti.
Small bowel transplantation, usually performed as a part of a multi-organ transplant, is still a relatively rare procedure, but aimed to solve life-threatening conditions.
Rezultati presaditev organov so se sčasoma prav tako izboljšali po zaslugi napredka v kirurških metodah, dostopnosti novih imunosupresivnih zdravil in večje izkušenosti kirurških in zdravstvenih delavcev, ki se ukvarjajo s presajanjem.
Results with organ transplantation have also progressively improved over time, thank to the advance in surgical techniques, availability of new immunosuppressive drugs, and longer experience of the transplant surgical and medical teams.
Letno poročilo ameriške mreže za pridobivanje in presajanje organov in znanstvenega registra prejemnikov organov (OPTN/SRTR) za leto 2006 navaja, da je po neusklajenih podatkih pri ameriških bolnikih, ki so v obdobju 1999–2004 prejeli ledvico od umrlega darovalca, izbranega po strožjih merilih, stopnja preživetja presadka po enem letu znašala 91 %, po treh letih 80 % in po petih letih 70 %.
According to the OPTN/SDRD 2006 Annual report, in the USA, one, three and five-year unadjusted graft survival was 91%, 80%, and 70%, respectively, for kidney recipients of deceased non expanded criteria donors who received their grafts during the period 1999-2004.
Stopnja preživetja pri bolnikih, ki so prejeli ledvico od darovalcev iz t. i. razširjenega kroga, je po neusklajenih podatkih za ista obdobja znašala 82 %, 68 % in 53 %.
For the same follow-up periods, unadjusted graft survival for kidney recipients of expanded criteria donors was 82%, 68%, and 53%.
Opazno je tudi postopno izboljšanje stopenj preživetja bolnikov po presaditvi jeter.
Improvement over time is apparent also regarding patient survival after liver transplantation.
Na primer: po podatkih španskega registra za presaditve jeter je bila stopnja preživetja bolnikov, ki so jim presadili jetra v obdobju 1984–1987, po treh letih 47,2-odstotna, pri presaditvah v obdobju 2003–2005 pa že 76,6-odstotna.
For instance, 3 year patient survival was 47.2% for patients transplanted in 1984-1987, increasing up to 76.6% for those patients receiving a liver during the period 2003-2005, according to the Spanish Liver Transplant Registry.
Podobne izboljšave v uspešnosti beleži tudi evropski register za presaditve jeter.
Similar improved figures are drawn up by the European Liver Transplant Registry.
Po podatkih mednarodnega registra za presaditve srca in pljuč je bila doba preživetja polovice odraslih bolnikov s presajenim srcem v obdobju 1982–1988 8,2 leta, pri bolnikih, ki so jim presadili srce v obdobju 1994–1998, pa se je povzpela na 10,2 leta; stopnje preživetja še naprej rastejo.
Half-life of adult heart transplanted patients during the years 1982 to 1988 was 8.2 years, reaching 10.2 years for those patients who received their grafts during the period 1994 to 1998 and survival figures continue to improve, according to the International Registry of Heart and Lung Transplantation.
Kljub temu bi bilo treba na področju presajanja organov rešiti še veliko težav: dolgoročno je neuspešnost presaditve največkrat posledica t. i. kronične zavrnitve in smrti z delujočim presajenim organom, kar se največkrat primeri v povezavi z boleznimi srca in ožilja.
Many problems though ought to be solved in the field of organ transplantation: grafts are mainly lost in the long-term due to the so called chronic rejection and death with a functioning graft, mainly occurring in the context of cardiovascular pathology.
Poleg tega kratkoročne in srednjeročne posledice imunosupresije skrajšujejo življenje prejemnikov organov in zmanjšujejo kakovost življenja.
Besides, short and long-term consequences of immune-suppression decrease longevity and quality of life of organ recipients.
Kljub tem težavam je najstarejša težava pri presajanju organov bistven razkorak med številom bolnikov, ki čakajo na presaditev, in številom bolnikov, ki dejansko dočakajo presaditev.
Despite these problems, organ transplantation faces an earliest barrier represented by the important gap existing between the number of patients waiting for a transplant and the number of patients who are indeed transplanted.
To je posledica pomanjkanja organov za presaditev glede na potrebe po organih.
This is due to the shortage of organs for transplantation in relation with organ demands.
Število bolnikov na čakalnih seznamih raste, medtem ko stopnja darovanja in število organov, namenjenih presaditvi, ne raste ali raste počasneje.
While the number of patients being included in the waiting list increases, the rate of donation and the number of organs available for transplantation does not increase or improves at a slower rate.
Rezultat kombinacije rastočega števila bolnikov na čakalnih seznamih in počasne rasti števila presaditev so daljše čakalne dobe.
The result of more patients joining the waiting list with a little increase in the number of patients transplanted is a longer time in the waiting list.
Čakanje na presaditev ledvice je drago ter lahko negativno vpliva na preživetje presadka in bolnika.
Time waiting for a kidney transplant is expensive and may have a negative impact on graft and patient survival.
Poleg tega se lahko poveča tudi število bolnikov, ki umrejo med čakanjem na presaditev.
Besides, the number of patients who may die while waiting for a transplant may also increase.
Čisto mogoče je tudi, da je pomanjkanje organov hujše, kot kažejo podatki, saj se zdravniki zaradi pomanjkanja morda izogibajo vpisovanju dodatnih bolnikov na čakalne sezname.
The shortage of organs for transplantation may be still underestimated, since the scarcity of organs may preclude physicians from including more patients into the waiting lists.
Glede na navedeno je hudo pomanjkanje organov splošen izziv na področju presajanja organov, s katerim bi se bilo treba soočiti z načrtovanim in usklajenim pristopom.
In this context, severe organ shortage represents a universal challenge in the field of organ transplantation, which should be faced under the scope of a planned and integrated approach.
POSTOPEK DAROVANJA PO MOŽGANSKI SMRTI
THE PROCESS OF DONATION AFTER BRAIN DEATH
Dejavnosti darovanja po smrti temeljijo predvsem na darovanju po možganski smrti.
Deceased donation activity is primarily based on donation after brain death.
Treba je poudariti, da to stanje doleti zgolj 1 % vseh umrlih in 3 % ljudi, ki umrejo v bolnišnici.
It has to be outlined the fact that no more than 1% of death people and no more than 3% of people who die in the hospital hits this situation.
Število možnih možgansko mrtvih darovalcev je torej omejeno.
Therefore, the number of potential brain dead donors is limited.
Z ozirom na to omejitev je težko izkoristiti potencial darovanja po možganski smrti, saj je darovanje in pridobivanje organov zelo občutljiv in kompleksen postopek, ki zahteva sodelovanje številnih akterjev in ga je mogoče v vsakem trenutku prekiniti.
Keeping in mind this limitation, the potential of deceased donation after brain death is difficult to reach, since organ donation and procurement is a very delicate and complex process that needs the cooperation of many actors and that can be broken at any time.
Poleg tega je treba postopek opraviti v zelo kratkem času, zaradi česar so slabosti samega postopka toliko bolj izpostavljene.
Even more, the whole process should take place in a very short period of time, what enhances the weaknesses of the process itself.
V tem postopku je mogoče opredeliti nekaj osnovnih korakov:
Several basic steps may be identified in this process:
· Odkritje darovalca : Vse morebitne darovalce je treba odkriti kar najbolj zgodaj.
· Donor identification : All potential donors should be identified at the earliest stage as possible.
Zgodnje odkritje bo olajšalo pregled in vzdrževanje darovalca, vendar nedvomno zahteva proaktiven pristop v tem prvem in ključnem koraku.
This early identification will facilitate donor screening and maintenance, but undoubtedly implies a proactive attitude at this first and crucial step.
· Pregled darovalca : Tveganje za prenos hudih bolezni s presaditvijo organa (neoplazija, okužba) z darovalca na prejemnika je treba kar najbolj zmanjšati.
· Donor screening : The risk of transmission of a serious disease through organ transplantation (neoplasia, infection) from the donor to the recipient should be minimized.
Treba pa je zagotoviti, da bodo zavrženi le tisti organi, ki so resnično neuporabni, da se prepreči neupravičena izguba organov.
However, it must be ensured that only organs that should be discarded are so, avoiding an unjustified loss of organs.
· Vzdrževanje darovalca : Pridobljene organe je treba pred presaditvijo nujno hraniti v primernih razmerah.
· Donor maintenance : It is essential that organs procured are kept in adequate conditions prior to retrieval.
Vzdrževanje fiziološkega stanja morebitnega darovalca na intenzivni negi ter pred in med odvzemom organov lahko močno vpliva na stanje organov.
The maintenance of the potential donor’s physiological state while on intensive care and of the donor prior to and during retrieval can make a major difference to the condition of the organs.
Slabo vzdrževanje darovalca lahko povzroči, da je organ neuporaben ali da se poveča verjetnost primarne zavrnitve.
Poor donor maintenance can make organs unusable or increase the incidence of primary graft failure.