KARACHI, Feb 19: Senior transplant surgeons and bio-ethicists have said that the proposed `Transplantation of Human Organs and Tissues Ordinance, 2007’ will fail to root out the sale of living kidneys in the country.

The federal cabinet on February 14 approved the draft of the ordinance aimed at regulating removal, storage, sale and transplantation of human organs and tissues.

Speaking at a press briefing on `Cadaver Law’ at the Sindh Institute of Urology and Transplantation (SIUT) on Monday, they demanded that the government ensure a complete elimination of transplants from unrelated donors, which brought considerable health complications for both the kidney recipient and the donor.

At present, in addition to local exploitation, patients from abroad, including those from some Middle-East countries, have lured so much the economically deprived donors that pools of kidney vendors have shaped up in different parts of the country, particularly in Punjab.

SIUT Director Prof Adibul Hassan Rizvi told the newsmen that the rate of ‘unrelated kidney transplants’, which was around 25 per cent in 1999, had increased up to 84 per cent by 2005. “In fact Pakistan has become a lucrative kidney trade centre since there is no law barring sale of human organs in the country,” he said.

According to him, the government should help encourage the ethical transplantations, the ones that involved a related donation, otherwise “it would be better not to have a law that would ultimately prove instrumental in the further growth if kidney bazaars in the country.”

The noted surgeon said that the SIUT, which had been advocating for “cadaver laws” for long, had really been disappointed to know that some major additions had been made in its draft on kidney transplant and donation laws, which was proposed originally in the 1990s. New laws were likely to come through a federal government ordinance, without consulting the SIUT and against the aspirations of medical practitioners and civil society members, he added.

Replying to a question, he said that the last interaction of the SIUT with the government on the cadaver law issue was held about a year back. “We had raised some questions and expressed our reservations to some provisions during the meeting, and thereafter, we have never been contacted despite the fact that we are one of the few major stakeholders,” Prof Rizvi said.

He was, however, hopeful that the civil society would again extend its support to the SIUT in getting the fresh draft rectified.

“I have been opposing the organ sale for long and will do it even more steadfastly in the future as well as I believe that there is no room for a free market’ in organ in this country,” the SIUT chief declared, adding that the SIUT team would like to convince the PM on the subject if an audience was provided by him.

Another senior surgeon, Dr Anwar Naqvi, said that due to lack of input of the transplant community, particularly the Transplant Society of Pakistan as well as the SIUT, some important aspects to safeguard ethical transplantation had been missing in the final draft of the legislation approved by the federal cabinet.

“In the category of living donors the scope had been enlarged to include second-degree donors and even the wet mothers and their children. Similarly the term non-blood relatives which previously included only spouses has now been enlarged by including in-laws and their relatives,” he said and added that such provisions would allow misuse of donors leading to commercialism in transplantation.

He also criticised the provision for an evaluation committee which would ensure that no organ or tissue was received from non-related living donors without the prior approval of the committee.

He said that the committee in question, with surgical specialist, medical specialist and a notable having an experience of social service, would not be suitable for determining the brain death as that was the domain of specialists such as neurosurgeons, neurophysicians and intensivists.

Dr Naqvi also noted that a monitoring committee as required by the ordinance had also been given the task of compensation to donor against organs, which shall be recovered from recipients.

Dr Farhat Moazzam, chairman of Centre for Biomedical Ethics and Culture said that it would have been in the fitness of things if the government had opted for adopting a draft bill proposed in 1994. “We believe that if some alterations are effected in clauses 3, 5 and 8 of the latest draft, Pakistan will be able to ensure healthy transplant activities,” she added.

She, who had gone through the ordinance draft in question, said that it was against the spirit of the Kuwait Document, which had been developed a couple of months back by consensus at a WHO workshop.

The draft opposes placing a monetary value of human organs, she said.