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 מחקר בנושא השתלת איברים

תת-חטיבה מחקרית זו, בתחום הפרופסיה הרפואית וביואתיקה, עוסקת בבחינה רב-תחומית של תחום השתלות האיברים: בחינה משפטית, אתית והיסטורית. כידוע, הבעיה המרכזית בתחום זה נובעת מכך שאיברים להשתלה הם בגדר משאבי בריאות חסרים. עובדה זו מציפה שאלות פרקטיות ומחקריות רבות, כגון: גילנות והשתלות .איברים; שאלות אתיות ופרקטיות של תרומת איברים; תהליך התרומה ושאלת האלטרואיזם בתרומות איברים  ועוד.


Eyal Katvan et al., “Age limitation for organ transplantation: the Israeli example”, 46(1) AGE & AGING (2017) 8.

In 2013 the Israeli Ministry of Health appointed a public committee to examine the policy of placing an age limitation on candidates listed for organ transplantation. The committee rejected the use of an age limit criterion for listing candidates for transplantation and recommended to abolish it. However, opinions differed regarding the use of recipients’ age in shaping a fair organ allocation policy. The committee's recommendations were adopted and put into force as of April 2014. This article unfolds the committee deliberations on accommodating values of formal equality for optimising the use of organ transplantation.

Jonathan Cohen, Tamar Ashkenazi, Eyal Katvan, Pierre Singer, “Brain Death Determination in Israel: The First Two Years Experience Following Changes to the Brain Death Law—Opportunities and Challenges”, 12 AM. J. OF TRANSPLANTATION (2012) 2514.  

To increase support for the concept of brain death, changes accommodating requirements of the religious authorities were made to the Brain Death Act in Israel. These included (1) considering patient wishes regarding brain death determination (BDD); (2) mandatory performance of apnea and ancillary testing; (3) establishment of an accreditation committee and (4) requirement for physician training courses. We describe the first 2 years experience following implementation (2010-2011). During 2010, the number of BDD decreased from 21.9/million population (during the years 2007-2009) to 16.0 (p < 0.001). Reasons included family resistance to brain death testing (27 cases), inability to perform apnea testing (7) and logistic problems related to ancillary testing (26 cases). The number of physicians available to declare brain death also decreased (210 vs.102). During 2011, BDDs increased to 20.5/million following the introduction of radionuclide angiography as an ancillary test; other reasons for nondetermination persisted (family resistance 26 cases, inability to perform apnea testing 10 cases). Instead of increasing opportunities, many obstacles were encountered following the changes to the Brain Death Act. Although some of these challenges have been met, longer term follow-up is required to assess their complete impact. 

Jonathan Cohen, Ruth Rahamimov, Aaron Hoffman, Eyal Katvan,  Kyril Grozovski and Tamar Ashkenazi, “Derivation and Implementation of a Protocol for Organ Donation after Cardio-Circulatory Death in Israel”, 19 THE ISRAEL MEDICAL ASSOCIATION JOURNAL  (2017) 566.   

Background: Strategies aimed at expanding the organ donor pool have been sought, which has resulted in renewed interest in donation after cardio-circulatory death (DCCD), also known as non-heart beating donors (NHBDs). Objectives: To describe the derivation and implementation of a protocol for DCCD in Israel and report on the results with the first six cases. Methods: After receiving approval from an extraordinary ethics committee at the Ministry of Health, the steering committee of the National Transplant Center defined and reached consensus on the unique challenges presented by a DCCD program. These protocols included clinical aspects (construction of a clinical pathway), social and ethical aspects (presentation of the protocol at a public gathering), legal/ethical aspects (consent for organ preservation procedures being either implied if the donor had signed an organ donor card or received directly from a surrogate decision maker), and logistic aspects (pilot study confined to kidney retrieval and to four medical centers). Data regarding organ donors and recipients were recorded. Results: The protocol was implemented at four medical centers. Consent for organ donation was received from four of the six potential donors meeting criteria for inclusion and in all cases from a surrogate decision maker. Of the eight kidneys retrieved, only four were suitable for transplantation, which was carried out successfully for four recipients. Graft function remained normal in all cases at 6–12 months follow-up. Conclusions: The DCCD program was successfully implemented and initial results are encouraging, suggesting that expansion of the program might further aid in decreasing the gap between needs and availability of organs.

Cohen, Ashkenazi, Katvan, Brain death determination in Israel: the first 9 years’ experience following changes made by the Brain and Respiratory Death Determination Law, IMAJ (forthcoming, 2021)

Cohen J., Katvan E., Ashkenazi T., Organ donation in the time of COVID-19: The Israeli experience one year into the pandemic – ethical and policy implications, Israel Journal of Health Policy Research

Eyal Katvan, Jonathan Cohen, , Ruth Rahamimov,and Tamar Ashkenazi, "A comparison of recalled pain memory following living kidney donation between directed  and non-directed, altruistic donors" Progress in Transplantation 

Tamar Ashkenazi, Jonathan Cohen, Daniel Gelman, Eyal Katvan, “The Psychological Examination and Evaluation of Unrelated Kidney Donors in Israel: A Suggested Model”, Psychology, Health & Medicine

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