KARACHI, Oct 26: Appreciating the existing Pakistani laws about organ transplantation, key national and international medical personalities at a public forum on Sunday said that any amendment to those laws might pave the way for commercial dealings in transplantations and hinder the promotion of a cadaver donation culture in the country.

Among others, senior representatives of the World Health Organisation and the International Transplant Society also spoke and informed the audience that their respective organisations had been keenly watching the organ transplant-related developments in Pakistan and it would be befitting if the government, legislators and the community of medical professionals continued discouraging transplant tourism activities and ensured that there was no further exploitation of the poor.

The forum, titled ‘Public symposium on organ donation,’ was organised by the Sindh Institute of Urology and Transplantation (SIUT) on the concluding day of its sixth international symposium of urology, nephrology and transplantation.

A couple of speakers also referred to the case of the Philippines, where most transplants performed now are living-related.

Coming from Boston, USA, Prof Francis Delmonics of the International Transplant Society said the wide gap between supply and demand of organs, including the kidneys, had prompted the introduction of commercialism in the realm of transplantation, which also entailed ethical problems such as organ trafficking from one country to another.

He maintained that trafficking was a shameful exploitation of individuals for money, which needed to be curbed by countries through serious implementation of the available legal tools and improvement of medical care facilities and promotion of organ donations after brain death.

Talking of what the WHO was doing to promote transplantations, Dr Luc Noel said that guidelines had been prepared to increase cadaver organ donations by following strict criteria for brain death and prohibition of financial profits by the sale of human body parts.

When asked to comment on the moves pertaining to proposals for amendments in the Pakistani Organ Transplant Ordinance of 2007, Dr Noel said the WHO had been consulted during the draft preparation of the law and he personally felt that there was no point in supporting the proposed amendments, which may reopen the door to exploitation of poor people.

The amendments in question were tabled in the National Assembly by a group of legislators in August, with the plea that there were some lacunae which needed to be removed.

Dr Mustafa Al Mousawi of the Middle East Society of Transplantation and Faisal Shaheen of the Saudi Centre of Transplantation said brain death donations were now being recognized in their countries and a significant increase in kidney transplantations had been observed in recent years.

Dr Mousawi stressed the need for establishing well-structured programmes for deceased organ donations, having, among other facilities, coordinators caring about well-trained nursing and medical staff at the intensive care units and education of families on the issue of cadaver donations.

Dr Vivekanand Jha, a nephrologists and representative of the Indian Society of Transplantations, called for raising public awareness on the subject of organ failures and ways to treat them, and undertaking of ethical organ transplantation with no room for monetary benefits for anyone.

Unclear concepts

Prof Adibul Hasan Rizvi, director of the SIUT and president-elect of the Transplant Society of Pakistan, said the concept of cadaver organ donation was not clear to both the health workers and the patients. The doctors lacked the confidence in declaring brain death, and the patients and the families thought that the organs after death were of no use to anybody, which needed to be addressed and removed through training of the medical staff and building trust among the medical professionals, the community and the government.

Talking of the proposed changes in the Organ Transplant Ordinance of 2007, Dr Farhat Moazzam, director of the Centre of Bio-Ethics and Culture at the SIUT, said that efforts were being made to amend the laws to create room for donations of organs from Pakistanis to foreigners and giving monetary benefits and allowing compensation to donors as well, which were certainly tantamount to restarting transplant tourism.

Referring to the reservations expressed during the public symposium, A.Q. Usmani, the administrator of the Human Organ Transplant Authority (HOTA) said there was no need to worry as the ministry of health and his institution were fully standing by the Transplantation of Human Organ and Tissues Ordinance, 2007, which had been remarkably helpful in checking the sale of organs and exploitation of the poor.

The HOTA chief said 539 transplantations had been carried out after the promulgation of the 2007 ordinance and all recipients were Pakistani, against a figure of 2,000 organ transplantations done annually before the enforcement of the law that included about 1,500 foreign recipients. He added that the authorities were extending necessary support in foolproof checking of organ transplants in the country and any attempt to damage the original spirit of the ordinance would be resisted accordingly.