Top doctors explain new organ transplant system
ABU DHABI // First details emerged yesterday of how the UAE's new organ transplant programme will work, with two of the country's most senior doctors stressing that patients with the most urgent clinical needs would be given priority. It was announced this week that ministerial approval had been given for an appendix to a law allowing transplants from deceased donors. Yesterday Dr Mohammed al Zaabi, an Emirati member of the National Organ Transplant Committee, said the programme could not prioritise organ recipients based on "nationality, ethnicity or religion".
"This is a crucial part of regulation," he said. "Doctors are ethically obliged not to be subject to pressures from outside to give priority of organs to certain people. The justice of organ distribution is very critical. In western countries at one point there was no justice, then they introduced a scoring system where they gave the organs to those who were in immediate need of a transplant." Dr Faisal Badri, the deputy chairman of the National Organ Transplant Committee and a liver transplant specialist, agreed, saying that there was "no way" any particular nationality would be given priority as recipients. "It cannot and will not work like that," he said.
Dr Badri, who is the head of general surgery at Rashid Hospital in Dubai, said because established transplant programmes existed in other parts of the world, it would be easier to encourage certain expatriates to agree to becoming donors. "Of course it is much easier to talk to European people because they already know about the programme, compared to local or some other Middle Eastern nationalities" he said.
"But what is so important is that everyone knows this will be a fair system. Otherwise I don't think they will do it." He said a committee would be set up in every transplant centre to prioritise patients. This list would be used on a federal level to make it fair, he added. "The transplant will be done according to the waiting list and severity of the condition of the recipient, nothing else." The transplant committee will discuss issues such as how to enrol donors and compile a database of donors' and potential recipients' details in order to find matches.
The committee will look at a system where potential donors choose to opt in or out when they apply for official documents such as a residency visa, driver's licence or ID card. This way, said Dr al Zaabi, the programme was likely to attract the maximum number of potential donors from all sections of society. Dr al Zaabi, a liver transplant specialist at the Zayed Military Hospital in Abu Dhabi, said several important decisions had to be made before transplants could begin.
He said the country was lagging behind, and finalising all the necessary details would be a "huge undertaking". "There are many things we need to decide," he said. "You cannot imagine the logistics of this. We need to train doctors, nurses and other medical staff. As well as other tasks like setting up blood banks to give a ready supply of blood." Officials had been working on the appendix for more than three years before its official release on Sunday.
It allows transplants of kidneys, liver, lung, pancreas and heart. There are more than 1,000 people in the UAE waiting for kidneys alone. According to the regulations, a deceased person's organs could be used if they signed a written will prior to their death agreeing to the surgery, or if the majority of their closest relatives agreed to it. The appendix ruled that only ministry-approved centres can perform transplants.
Dr al Zaabi said the committee would also consider how many clinics are needed, and how they are to be paid for. All 23 transplants from live donors performed at Sheikh Khalifa Medical City, the only authorised transplant centre in the country, were funded by the Government, he said. "So far it is funded by the Government and only done at Sheikh Khalifa Medical City," said Dr al Zaabi. "We need to work out what we need but I imagine it will be publicly funded. Getting the definition of brain dead was just the first step."
Published: May 20, 2010 04:00 AM