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"Latar Belakang: Donasi organ merupakan isu etis, moral, dan medis yang kompleks. Donor organ berpotensi mengalami masalah psikososial pascadonasi, seperti depresi, cemas, stres, dan kekhawatiran akan kondisi kesehatannya. Donasi organ juga sering dikaitkan dengan isu perdagangan organ yang masih marak di Indonesia. Hingga saat ini, belum ada kesepakatan resmi mengenai domain konstruk pemeriksaan yang mendasari penulisan laporan kelaikan donor organ dalam bidang psikiatri. Hal ini dapat menyebabkan ketidakseragaman penulisan yang berpotensi mengakibatkan terlewatnya aspek psikososial yang penting untuk diidentifikasi dan meningkatkan risiko terjadinya masalah hukum. Oleh karena itu, identifikasi domain konstruk dari laporan pemeriksaan diperlukan untuk menetapkan panduan yang selanjutnya dapat dijadikan dasar pengembangan instrumen pemeriksaan kelaikan donor organ hidup di Indonesia. Metode: Penelitian menggunakan desain mixed method. Pendekatan kualitatif ditujukan untuk mengidentifikasi domain konstruk pemeriksaan menggunakan metode diskusi kelompok terpumpun (DKT) dengan 2 orang pakar. Data kualitatif dianalisis menggunakan conventional content analysis dengan tipologi thematic survey. Pendekatan kuantitatif ditujukan untuk menentukan proporsi kesesuaian penulisan laporan dengan domain konstruk pemeriksaan dan kontribusi tiap domain terhadap simpulan kecakapan yang diambil oleh pakar pada 404 laporan kelaikan donor ginjal dan hati dalam bidang psikiatri di RSCM yang diambil menggunakan metode total sampling. Analisis kuantitatif menggunakan uji Chi-square dan regresi logistik. Hasil: Analisis data kualitatif menghasilkan 9 kategori, yaitu sosiodemografi, motivasi, relasi dengan resipien, pemahaman, perasaan terhadap keputusan menjadi donor, resiliensi, isu psikiatri, penggunaan zat psikoaktif, dan isu legal. Didapatkan ketidakseragaman penulisan domain konstruk pada laporan, dengan proporsi penulisan terkecil pada domain penggunaan zat psikoaktif (5,45%) dan motivasi (82,18%). Faktor-faktor yang berperan memprediksi simpulan kecakapan calon donor adalah aspek pendidikan, motivasi, relasi dengan resipien, pemahaman, perasaan terhadap keputusan menjadi donor, resiliensi, isu psikiatri, dan isu legal dengan R2 sebesar 0,649. Simpulan: Terdapat 9 domain yang menyusun konstruk pemeriksaan kelaikan donor organ hidup dalam bidang psikiatri di RSCM. Domain yang paling memprediksi simpulan kecakapan adalah pemahaman dan resiliensi.

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Background: Organ donation is a complex ethical, moral, and medical issue. Organ donors are at risk for post-donation psychosocial problems, such as depression, anxiety, stress, and worries about their health condition. Organ donation is also associated to illegal organ-trafficking which is still a problem in Indonesia. To date, there has been no official agreement on the domains of psychiatric assessment that underlies the construct of living donor eligibility report. This can lead to the diverseness of reports which can potentially result in undetected important psychosocial aspects and increased legal risks. This research was conducted to identify domains on the psychiatric assessment of living organ donor eligibility report, which can then be used as the basic data for developing psychiatric living donor assessment instrument in Indonesia. 

Methods: This study used a mixed-method approach. A qualitative approach aimed at identifying domains of the psychiatric assessment using focus group discussion (FGD) with 2 experts. The qualitative data were analyzed using conventional content analysis with thematic survey typology. A quantitative approach aimed at determining the conformity of the reports and the contribution of each domains towards donor’s suitability concluded by experts on 404 living donor eligibility reports taken using total sampling method. The quantitative data were analyzed using Chi-square and logistic regression test. 

Results: The qualitative approach resulted in 9 categories: sociodemography, motivation, relationship with recipient, understanding, feelings toward the decision to become donor, resilience, psychiatric issues, use of psychoactive substances, and legal issues. There was inconsistency on the domains written in the reports, with the least written domains are use of psychoactive substances (5,45%) and motivation (82,18%). Based on the multivariate analysis, the domains that played a role in predicting donor’s suitability were education, motivation, relationship with recipient, understanding, feelings toward the decision to become donor, resilience, psychiatric issues, and legal issues with an R2 of 0,649.

Conslusion: There are 9 domains that make up the construct of psychiatric assessment of living organ donor eligibility in RSCM. Domains that most predict the psychiatric eligibility conclusion are understanding and resilience of the donor candidate."

"Latar belakang: Kelainan kornea merupakan salah satu penyebab utama kebutaan dan gangguan penglihatan di Indonesia. Penanganan gangguan penglihatan karena kornea terhambat karena terbatasnya jumlah donor kornea. Pendekatan rumah sakit yang dipengaruhi oleh pengetahuan, sikap, dan perilaku tenaga kesehatan terhadap pelayanan donor kornea dapat menjadi strategi mengatasi kekurangan donor kornea. Tujuan: Mengetahui gambaran pengetahuan, sikap, dan perilaku perawat di Rumah Sakit dr. Cipto Mangukusumo (RSCM) terhadap pelayanan donor kornea. Metode penelitian: Pemilihan subjek menggunakan teknik quota sampling dan pengisian kuesioner yang teruji validitas dan reliabilitasnya. Hasil: Terdapat 422 responden dengan proporsi unit instalasi gawat darurat, ruang rawat inap intensif, ruang rawat inap non intensif, rawat jalan, dan ruang operasi secara berurutan sebesar 8,3%, 13,7%, 50%, 16,6%, dan 11,4%. Sebagian besar responden memiliki pengetahuan kurang (55,4%), sikap positif (50,2%), dan perilaku baik (59,5%). Terdapat hubungan signifikan antara tingkat pengetahuan dan sikap responden terhadap perilaku, namun tidak terdapat hubungan antara faktor demografi dengan perilaku. Usia ≤ 36 tahun, pengetahuan baik, dan sikap positif merupakan faktor prediktor perilaku baik. Kesimpulan: Terdapat hubungan antara pengetahuan dan sikap terhadap perilaku perawat RSCM terhadap pelayanan donor kornea di rumah sakit.

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Background: Corneal blindness is one of the leading cause of blindness and visual disturbances in Indonesia. The management of corneal blindness in Indonesia is impeded by the rarity of corneal donor. Hospital approach affected by knowledge, attitude, and practice of health workers could be a strategy to improve the scarcity of corneal donor. Purpose: Determine the knowledge, attitude, and practice of nurses in RSCM toward hospital corneal procurement Methods: Subjects are chosen by quota sampling and surveyed with a valid and reliable questionnaire. Results: There were 422 respondents with the proportion of emergency ward, intensive care, non-intensive care, polyclinics of 8.3%, 13.7%, 50%, 16.6%, and 11.4% respectively. Most of the respondent were lacking in knowledge (55.4%), had positive attitude (50.2%), and had good practice (59.5%). There were significant correlation between knowledge and attitude towards practice but no significant correlation found between demographic factors to practice. Age ≤ 36 years old, good knowledge, and positive attitudes are predictor factors for good practice. Conclusion: There were correlation between knowledge and attitude of health workers in RSCM towards practice of corneal donor procurement in hospital."

"Skripsi ini membahas mengenai pengaturan transplantasi organ ditinjau dari perspektif Hak Asasi Manusia (HAM) serta menganalilis perbandingan hukum antara Indonesia dan Malaysia. Pemberian imbalan materiil maupun imateriil dalam transplantasi organ tidak diizinkan dengan dalih apapun. Berkaitan dengan hal tersebut, tujuan penulisan skripsi ini adalah untuk menganalisis pengaturan mengenai transplantasi organ ditinjau dari perspektif HAM bagi Pendonor maupun Resipien. Skripsi ini juga akan menganalisis perbandingan hukum Indonesia dan Malaysia, mengingat Malaysia merupakan negara yang juga melarang adanya jual beli organ. Metode penelitian yang digunakan untuk penulisan skripsi ini adalah metode penelitian hukum normatif. Dalam metode penelitian normative, penelitian ini akan menggunakan implementasi ketentuan hukum normatif (undang-undang) yang berlaku di Indonesia dan Malaysia. Indonesia dan Malaysia melarang adanya praktik jual beli organ dan menegaskan bahwa transplantasi organ dilakukan hanya untuk tujuan kemanusiaan. Walaupun Pendonor menyetujui untuk menjual organnya, jual beli organ tetap tidak diizinkan. Perlu adanya badan resmi negara yang mengawal jalannya proses transplantasi organ. Badan tersebut disebut dengan Komite Transplantasi Nasional.

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This thesis analize organ transplantation from the Human Rights Perspective and comparing the law between Indonesia and Malaysia about organ transplantation. Material nor immaterial rewards are not permitted under any pretext. In this regard, the purpose of this thesis is to analyze law related to organ transplantation from a human rights perspective either for donors and also recipients. This thesis will also discuss the laws of Indonesia and Malaysia related to organ transplantation because Malaysia also prohibit the existence of organ trading. The research method used to study this thesis is the normative legal research method. In the normative research method, this research will use laws and regulations in Indonesia and Malaysia. Indonesia and Malaysia prohibit the existence of organ trading and only approve organ transplantation for humanitarian goals. Although the donor is approved to sell their organs, buying and selling organs is still not permitted. An official state agency is needed to oversee the process of organ transplantation. The official state agency is called the Komite Transplantasi Nasional. "

"Latar Belakang:.Donor transplantasi hati merupakan manusia yang sehat. Kualitas pelayanan transplantasi yang baik dinilai berdasarkan kualitas hidup donor dan resipien hati. Evaluasi kualitas hidup pasien donor hati sintas dan nonsintas merupakan hal yang penting untuk setiap pusat pelayan transplantasi hati.Metode: Dilakukan penilaian kualitas hidup seluruh donor hati di Rumah Sakit Cipto Mangunkusumo (RSCM) dengan mengunakan World Health Organization Quality of Life questionnaire abbreviated version (WHOQoL-BREF). Kualitas hidup donor hati dengan resipien sintas dan nonsintas dibandingkan.

Hasil: Terdapat 59 donor hati di RSCM. 3 subjek tidak bisa dihubungi, 1 subjek menolak untuk menjadi subjek penelitian. Kualitas hidup donor hati pada memiliki median domain fisik 69 (44-100), pada doman psikologis 69 (50-94), domain hubungan sosial 65 (44-100) dan domain lingkungan 69 (31-94). Tidak terdapat perbedaan bermakna antara kualitas hidup donor hati sintas dan nonsintas pada domain fisik (p=0,466), domain psikologis (p=1,00), domain hubungan social (p=0,77) dan domain lingkungan (p=0,13).

Kesimpulan: Subjek donor transplantasi hati di RSCM memiliki kualitas hidup yang baik. Tidak ada perbedaan bermakna kualitas hidup subjek donor transplantasi hati antara resipien sintas dan non sintas.

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Background: Liver donors are healthy people. The quality of liver transplantation is assessed based on the quality of life of donors and recipients. Evaluation of the quality of life of liver donors with surviving and non-surviving recipients is important for liver transplant centers.

Method: Quality of life of liver donors in RSCM was assessed using World Health Organization Quality of Life questionnaire abbreviated version (WHOQoL-BREF). The quality of life of donors with surviving and non-surviving recipients is compared.

Result: There are 59 liver donors in RSCM. Three subjects could not be contacted, one subject refused to participate in this research. Donors’ Quality of life physical domain median was 69 (44-100), psychological domain median was 69 (50-94), social relation domain median was 65 (44-100), and environmental domain median was 69 (31-94). There were no significant differences between the quality of life of donors with surviving and non-surviving recipient in physical domain (p=0,466), psychological domain (p=1,00), social relation domain (p=0,77), and environmental domain (p=0,13).

Conclusion: Liver donors in RSCM have good quality of life. There were no significant differences in quality of life of liver donors between Bedah Digestifsurviving and non-surviving liver recipients."

"Pendahuluan: Hal yang penting untuk transplantasi hati donor hidup (LDLT) yaitu risiko morbiditas dan mortalitas minimal terhadap donor hidup yang sehat. Tujuan dari penelitian ini yaitu untuk menganalisis seluruh komplikasi pascadonor dengan derajat beratnya komplikasi dikelompokkan berdasarkan klasifikasi Clavien-Dindo yang dikombinasikan dengan Comprehensive Complication Index (CCI) dan untuk menganalisis faktor-daktor yang berhubungan dengan komplikasi pascaoperasi.Metode: Penelitian ini menggunakan desain potong lintang. Terdapat 53 pasien dengan rekam medis lengkap dan menjalani LDLT di RSUPN Cipto Mangunkusumo, Jakarta, pada Desember 2010 dan Januari 2019. Seluruh subjek penelitian dianalisis secara retrospektif. Penelitian ini telah lolos kaji etik dengan nomor surat No 93/UN2.F1/ETIK/2019.Hasil: Dari 53 pasien yang menjalani LDLT di RSCM, terdapat 7 pasien yang menjalani prosedur transplan hati adult-to-adult dan 46 pasien menjalani prosedur transplan hati adult-to-child. Pada kelompok pasien transplan adult-to-child, sebanyak 43 pasien merupakan donor lobus kiri lateral, 4 pasien donor lobus kiri, 2 pasien donor lobus kiri total, dan 4 pasien donor lobus kanan total. Komplikasi pascaoperasi dilaporkan pada 18 donor (33%). Terdapat 3 (5,6%) pasien dengan klasifikasi Clavien-Dindo derajat IIIa atau lebih berat dengan skor CCI keseluruhan yaitu 10,45 (8,7-55,8). Terdapat 1 dari 53 donor (1,8%) dengan komplikasi bilier derajat III yang membutuhkan ERCP dan ditata laksana dengan stenting bilier dan sfingterektomi. Reoperasi terkati hepatektomi donor dilakukan pada 1 donor akibat infeksi daerah operasi dalam. Tidak ada insidensi gagal hati pascahepatektomi dan mortalitas perioperatif sejak awal prosedur transplantasi hati dilakukan.Kesimpulan: Morbiditas pasca-LDLT berhubungan dengan pengalaman pelaksana. Sistem klasifikasi Clavien-Dindo yang dikombinasikan dengan CCI bermanfaat dalam memperkirakan hasil prosedur.

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Introduction: The crucial prerequisite for living donor liver transplantation (LDLT) is minimal morbidity and mortality risk to the healthy living donor. The purposes of this study were to analyze all post donor complications according to severity using Clavien-Dindo Classification (CDC) integrated with Comprehensive Complication Index (CCI) and to identify factors related to post-operative complications.

Methods: The cross-sectional design was used. A total of 53 patients, with complete medical records, who underwent LDLT in Cipto Mangunkusumo Hospital Jakarta (RSCM) between Desember 2010 and January 2019 were retrospectively analyzed. Ethical approval No 93/UN2.F1/ETIK/2019.

Results: Of 53 patients underwent LDLT at RSCM, 7 patients underwent adult-to-adult liver transplant and 46 patients underwent adult-to-child liver transplant. Of these, 43 were donors of the left-lateral lobe, 4 were of the left lobe, 2 were full-left lobes, and 4 were of the full-right lobe. Postoperative complications were reported in 18 (33%) donors. There were 3 (5.6%) patients in CDC grade IIIa or greater and the overall CCI was 10.45 (8.7-55.8). Only 1 out of the 53 donors (1.8%) had a grade III biliary complication requiring ERCP and managed with biliary stenting and sphincterotomy. Re-operation related to donor hepatectomy was done in 1 donor due to deep incisional surgical site infection. No incidence of post hepatectomy liver failure and perioperative mortality were recorded since inception of the liver transplantation program.

Conclusions: Morbidity after LDLT strongly correlates to center experience. The CDC grading system integrates with CCI is useful to comprise surgical outcomes."

"This volume aims to cover important aspects of the various facets of organ transplantation and regenerative medicine."

"ABSTRACTBACKGROUND:kidney transplantation has been developing rapidly in Indonesia in recent years, yet data on transplants' characteristics and survival is still unavailable. In Indonesia, only living donors are permitted. Living donor are advantageous, but challenging to recruit. This study aimed to establish the graft and patient survival rates and to describe the characteristics of recipient and donor as well as the process of donor recruitment and evaluation of kidney transplantation in Indonesia.METHODS:the study was a retrospective cohort on all donors and kidney transplant recipients at Cipto Mangunkusumo General Hospital (CMGH) from January 2011 to May 2017. Only recipients from January 2011 to May 2014 were included to establish the 1-year and 3-year graft and patient survival; which were described using Kaplan-Meier method. RESULTS:data from 492 kidney transplant procedures were obtained (donor median age, 30 (17 - 66) years; 25.1% were family-related. Recipients mean age, 47 (SD 13.18 years). Data from total of 138 kidney transplant recipients were further analyzed. The 1-year death- censored graft survival, all-cause graft survival and patient survival were 92 %, 82.6 % and 87%. The 3-year death-censored graft survival, all-cause graft survival and patient survival were 90.6%, 76.1% and 79.7%. Kaplan-Meier's curve showed the highest mortality rates occured in the early months.CONCLUSION:the 1-year graft and patient survival rate were 92% and 87%. The 3-year graft and patient survival rate were 90.6% and 79.7%. Only small percentage of donor were family-related. Living donor recruitment and evaluation are still a big challenge in Indonesia"

"Berkembangnya ilmu pengetahuan dan teknologi di bidang medis, memungkinkan terobosan baru di bidang kesehatan. Setiap orang yang mengidap suatu penyakit yang menyerang organ dan atau jaringan tubuhnya kini memiliki harapan baru untuk dapat hidup dengan kehidupan yang lebih berkualitas. Begitu pula dengan seseorang yang telah meninggal dunia, dapat terus berbuat baik dengan menolong sesamanya melalui transplantasi organ dan atau jaringan tubuh manusia. Transplantasi organ dan jaringan tubuh manusia ini perlu diatur dalam suatu peraturan tertentu karena sarat atas permasalahan hukum. Selayaknya hukum kesehatan, hukum transplantasi organ dan jaringan tubuh memiliki aspek hukum perdata, pidana, dan administrasi. Perbedaan ideologi, budaya, serta kepercayaan yang dianut oleh masing-masing negara menyebabkan perbedaan pengaturan transplantasi organ dan jaringan tubuh manusia di negara yang satu dengan lainnya. Luasnya aspek hukum yang terdapat dalam transplantasi organ dan jaringan tubuh manusia, membuat penulis membatasi pembahasan penulisan ini hanya mengenai aspek hukum perdatanya saja. Penulisan ini membahas tentang perbandingan pengaturan transplantasi organ dan jaringan tubuh manusia di Indonesia dan Singapura ditinjau dari aspek hukum perdata beserta implikasi dari pengaturan tersebut. Perbedaan pengaturan transplantasi organ dan jaringan tubuh manusia di negara-negara tersebut menyebabkan implikasi yang berbeda pula.

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Improving sciences and technologies in medical matters allow us to experience a new miracle. People who are dealing with end-stage organ failures can have a new hope of living in health and meaningful life. In other hand, a deceased people could still also do a favor for others in need by donating his organ or tissue with transplantation. Human organ and tissue transplant needs to be regulated in such regulation in order to maintaining legal issues it may cause. Like medical law, organ and tissue transplant also related with private law, criminal law, and administration law matters. The differences in ideology, cultural, and belief that hold by different countries, lead to a different regulations among countries, not only, but including regulations in human organ and tissue transplant. The wide range of legal aspects in regard with human organ and tissue transplant, require the writer to limit the writing of this paper. The purpose of this writing is to compare the regulations of organ and tissue transplantation in Indonesia and Singapore in terms of private law aspects. Furthermore, this writing is showing the reader about the implication of the different regulations of organ and tissue transplant in those countries."

"Introduksi: Transplantasi hati merupakan terapi definitif pasien dengan penyakit hati stadium akhir. Peningkatan lama rawat inap berhubungan dengan luaran yang lebih buruk. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan peningkatan lama rawat inap pada pasien anak pascatransplantasi donor hidup di RSUPN Dr. Cipto Mangunkusumo. Metode: Penelitian potong lintang ini dilakukan dengan subjek seluruh pasien anak (<18 tahun) pascatransplantasi donor hidup di RSUPN Dr. Cipto Mangunkusumo pada tahun 2020-2018. Data social demografis dan klinis didapatkan pada penelitian ini. Uji T berpasangan dan uji T independent dilakukan pada subjek. Analisis multivariat dilakukan pada variabel dengan nilai p <0,25 dianggap signifikan. Hasil: Terdapat 32 subjek pada penelitian ini. Graft-to-recipient weight ration (GRWR) berkorelasi terbalik dengan lama rawat inap (p= 0,010, r = -0,447). Variabel lain, jenis kelamin, umur, durasi operasi, waktu iskemia, status nutrisi, rasio graft-to-weight, etiologi, aliran vena porta, dan komplikasi tidak berkorelasi secara signifikan dengan peningkatan lama rawat inap (p>0,05). Konklusi: Peningkatan lama rawat inap berkorelasi terbalik secara signifikan dengan GRWR.

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Introduction: Liver transplantation is a definitive treatment for pediatric end-stage liver disease. Increased length of stay (LOS) was associated with worse outcome. The study was aimed to analyze the factors related to the increase of LOS in pediatric patients receiving LDLT in Cipto Mangunkusumo General Hospital.

Methods: A cross-sectional study was performed, with patients collected from children (<18 years old) receiving LDLT in Cipto Mangunkusumo General Hospital in 2010 - 2018. Sociodemographic and clinical data were collected in the study. Paired t-test and independent t-test was performed on the patients included in the study. Multivariate analyses were performed for variables with p value <0.25. P value of < 0.05 was deemed significant.

Results: There were 32 subjects included in the study. Graft-to-recipient weight ratio (GRWR) had significant inverse correlation to LOS (p = 0.010, r = -0.447). Other variables, namely sex, age, surgery duration, ischemia time, nutritional status, graft-to-weight ratio, etiology, portal vein flow, and complications were not significantly correlated with increased LOS (p > 0.05).

Conclusion: Increased LOS was significantly and inversely correlated with GRWR."