Ass. Prof. Jacob Lavee
雅各•拉維 副教授
雅各•拉維 副教授
主要學歷：
Medical School (graduated magna cum laude) – Sackler Faculty of Medicine,
Tel Aviv University, Tel Aviv, Israel. (1970-1977)
現職：
n 以色列特拉維夫大學賽克勒醫學院外科學科副教授 (Associate Professor of Surgery, Tel Aviv University Faculty of Medicine)
n 以色列希巴醫療中心心臟移植部主任 (Director, Heart Transplantation unit, Sheba Medical Center)
n 以色列希巴醫療中心心臟外科部代部主任 (Deputy Director, Dept. Cardiac Surgery, Sheba Medical Center)
n 以色列器官移植協會會長（President, Israel Society of Transplantation, 2008 - Present）
經歷：
n 以色列希巴醫療中心血管外科住院醫師（Sheba Medical Center Cardiothoracic Surgery Residency, 1982-1988）
n 美國匹茲堡大學醫學中心心臟移植臨床研究醫師（University Of Pittsburgh Heart Transplantation Fellowship, 1989-1990）
n 以色列心血管暨胸腔外科學會會長（Chairman, Israel Society Of Cardiothoracic Surgery , 1999-2005）
Deceased and living organ donation and transplantation in Israel following implementation of a new Organ Transplant Law
Prof. Jacob Lavee, MD
Director, Heart Transplantation Unit, Leviev Heart Center,
Sheba Medical Center, Ramat Gan
The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
Israel National Transplant Center, Ministry of Health, Tel Aviv, Israel
Background:During the last decade Israel's organ donation rate has been among the lowest in Western countries.Cultural and religious objection towards recognition of brain death among parts of the society, combined with “free riding” behavior of these elements regarding accepting organs for transplants, as well as generous reimbursement of transplant tourism by insurance agencies regardless of the legality of the transplant operation performed abroad, have all contributed to these lower donation rates. A unique new Organ Transplantation Law, drafted to counter-balance these phenomena, and a law defining brain death determination, made a marked impact on the Israeli organ transplantation scene.
Methods:In March 2008 Israel's Parliament passed into legislation two laws relevant to organ transplantation: (A) The Brain Death Law which defines the precise circumstances and mechanisms to determine brain death; (B) The Organ Transplantation Law which includes several unique clauses:(1)Total ban of reimbursing transplants performed abroad if they are performed under the definitions of organ trade or against local laws; (2) Granting prioritization in organ allocation to candidates for organ transplantationwho have either been registered as organ donors for at least 3 years prior to being listed as candidates or have beenlive kidney or liver-lobe donors or have given their consent for actual organ donation of their deceased next-of-kin; (3) Removing disincentives for living donation by providing modest insurance reimbursementand some social supportive services. The impact of the gradual implementation of these new laws has finally been witnessed in the 2011 annual results of Israel’s NationalTransplant Center.
Results: In 2011 there were 89 deceased organ donors compared to 60 in 2010, which represents an increase in organ donation rate from 7.8 donors per million population to 11.4 (p=0.01). In 2011 267 organ transplantations from deceased donors were performed compared to 157 in 2010. Consent rate for organ donation from deceased donors has risen from 49% in 2010 to 55% in 2011 and deceased organ donation rate per million population has increased from 7.8 to 11.4 (p=0.01).The monthly number of new registered donors has risen from a mean number of 2889 in the years 1998 - 2010 to a monthly mean of 6273 in 2011, representing an increase in registered donorsfrom 10% to 12% of the adult population. Kidney transplantations from living donors have risen from 71 in 2010 to 117 in 2011 (p=0.003).The annual number of patients who underwent kidney transplantation abroad has sharply dropped since 2008 from 155 in 2006 to an all-time low of 35 in 2011 (p=0.006). Total number of candidates waiting for an organ transplant has dropped for the first time in decade from 1117 in January 2011 to 1041 in January 2012. Similarly, the total number of candidates who died while waiting for transplants has dropped from 124 in 2010 to 105 in 2011.
Conclusions: The implementation of the new Israeli Organ Transplantation Law, along with the Brain Death Law,has resulted in a significant increase in organ transplantations both from deceased donors, by prioritizing holders of donor cards, and from living donors, by removing disincentives for living donation.In addition transplant tourism from Israel was brought to an almost complete halt by banning its reimbursement.
