Swap transplants

Published March 10, 2022

IRONICALLY, the Punjab government’s recent step in the effort to stop organ trafficking may well end up providing a shot in the arm to the illegal transplant racket. At a meeting chaired by the Punjab health minister, the provincial government has given its approval to a swap transplant plan which expands the living donor pool beyond immediate family members. According to the law, a living donor must be “a close blood relative” (the term includes spouse); if such a donor is not available, an evaluation committee may allow a “non-close blood relative” to donate. In all situations, however, the transplantation must be “voluntary, genuinely motivated and without any duress or coercion”. Organ swap transplants, or paired exchanges, work by matching a recipient-donor pair that is medically incompatible, with another pair in a similar predicament. An organ ‘swap’ can then take place between the two pairs. However, these are only the bare bones of the procedure. It must be carried out according to strict ethical and clinical guidelines if it is not to open the floodgates for illegal transplants. Among these is the requirement that each recipient-donor pair must meet the eligibility criteria laid out in the law. Moreover, the age, renal function and tissue match of the two donors must be similar, so that the transplant swap has similar chances of success. Both transplantation procedures should also take place simultaneously to preclude a situation where one donor backs out after the recipient related to them has received their donated organ.

Thus, while paired exchanges are an accepted method of addressing donor-recipient incompatibility, the level of oversight mechanisms needed to prevent abuse are daunting — even more so in an unequal society riddled with corruption. The first paired kidney exchange in Pakistan was performed in 2015 at the Sindh Institute of Urology and Transplantation in Karachi; only seven more have taken place since then — all at SIUT — partly because of the extreme diligence that the process calls for. The troubling fact is that most illegal transplants take place in Punjab; some were found to have been carried out surreptitiously in KP and Azad Kashmir by doctors from Punjab. The situation in recent years had improved considerably after several organ trafficking gangs were busted, again mostly in Punjab. Does the province have a system in place to ensure that unethical individuals do not use the organ swap programme as a cover for illegal transplants?

Published in Dawn, March 10th, 2022

Opinion

Editorial

Banning PTI
Updated 16 Jul, 2024

Banning PTI

It appears that the govt and its backers within the establishment have still not realised that they are in uncharted territory.
Nato at 75
16 Jul, 2024

Nato at 75

EMERGING from the ashes of World War II, and locked in confrontation with the Soviet-led Communist bloc for over ...
Non-stop massacres
16 Jul, 2024

Non-stop massacres

Netanyahu is cunningly pretending to talk peace while mercilessly pounding Gaza. What is clear is that a return to pre-Oct 7 status quo is impossible.
Afghan challenge
Updated 15 Jul, 2024

Afghan challenge

Foreign states must emphasise to the Afghan Taliban diplomatic recognition and trade relations all depend on greater counterterrorism efforts.
‘Complete’ justice
15 Jul, 2024

‘Complete’ justice

NOW that the matter of PTI’s reserved seats stands resolved, there are several equally pressing issues pertaining...
Drug fog
15 Jul, 2024

Drug fog

THE country has an old drug problem. While the menace has raged across divides of class and gender, successive ...