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Financial and Legal Aspects of the Organ Transplantation

Ognjen Ridjic, Goran Ridjic, Izet Masic, Sahib Muminagic, Osman Slipicevic, Novka Agic, Jasenko Karamehic.

Abstract
In practical terms, whenever tissues are transplanted from one person to another it is essential to suppress the immune response of the recipient, no matter how perfect the HLA matching has been. When cellular (i.e. histo) compatibility differences exist, between donor and recipient, it is necessary to modify or suppress the immune response in order to enable the recipient to accept a graft. Immunosuppressive therapy, in general, suppresses all immune responses, including those to bacteria, fungi, viruses and even malignant tumors. Current scientific research and real life experiences show that the immunosuppression process can be more safely induced by utilizing the pharmacological means. Agents used in humans to suppress the immune response are discussed in more detail in the continuation of our paper. Financing of the organ transplantation will most probably be among one of the key questions, which need to be answered, before the patients begin to undergo this complex, tedious and costly procedure. The average actual costs and the associated financial contributions for the transplantation of liver and kidney, as well as other organs, have been reduced in the last decade. The main reason for this cost reduction is particularly the reduction of the time period of the patients’ hospital stay. Other reasons that contribute to this reduction, among others, include, (e.g. the pressure from the taxpayers as well as the increased innovation and availability of the new, highly potent and more effevctive and efficient immunosuppressive agents). The process of the cost estimation, in simplified terms, usually includes the costs involved in the following actions and procedures: (i.e. in the evaluation of the transplantation suitability, proper maintenance of the transplantatory candidacy, the costs related to the procurement of the compatible organs from the living and deceased-cadaveric donors, all hospital and physicians’ costs, post transplant care as well as the funding of the cost of the immunosuppressive medications within the first year after the organ transplantation). Finally, the aspect of the interest group lobbying and their effect on the key policy decision makers must also be mentioned. The population of patients who, due to their medical conditions, have to prepare for, undergo and follow up after the organ transplantation, by utilizing the special and costly immunosuppressive therapy must have the keen interest in improving their medical, legal and financial status.

Key words: immunosuppressive agents, immunosuppression, organ transplant, financial aspects of the immunosuppressive therapy prior, during and after transplantation.



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