x Abu Dhabi, UAESaturday 20 January 2018

The phone call that broke new ground for UAE's organ transplant law

A Emirati patient in Al Ain has become the first in the country to recieve an organ donation from a dead person.

ABU DHABI // The first organ transplant from a deceased donor is being hailed a success – but it took 20 years to come to pass.

Transplants were legalised in 1993 but the law failed to include a medical definition of death.

Ambiguity over whether this included a patient being brain dead, or solely a victim of cardiac death, meant it was impossible to use organs from deceased patients.

But the Ministry of Justice, Ministry of Health and Awqaf (General Authority of Islamic Affairs and Endowments) have now endorsed brain death – a medical milestone that could benefit more than 1,500 patients across the country on kidney dialysis.

The first donation from a deceased patient took place last month, with a kidney being flown from Saudi Arabia.

The call came at 9am on April 24 from the Saudi Centre for Organ Transplant, with doctors at Sheikh Khalifa Medical City offered the kidney of a Saudi man who had been killed in a road smash.

"We had already been in negotiation in the past to share organs," said Ammar Abdulbaki, a consultant and transplant nephrologist. "There is a GCC agreement that 10 per cent of the organs can and should be shared among the GCC countries."

After the Saudi Ministry of Health gave the green light, potential recipients were contacted, said Dr Abdulbaki, who used to work at the Saudi centre.

A shortlist of seven was whittled down to one, Latifa Sai'ed, 23, from Al Ain, who had been on dialysis since the age of 7.

Harvested at 2.25pm, the kidney was packed in ice and flown from Riyadh on a medical evacuation plane, arriving in Abu Dhabi at 10pm.

It took a further four hours to complete cross matching, a test to determine how the recipient could respond to the donor kidney, before the successful surgery went ahead.

The nationality of the donor was a deliberate choice, said Dr Abdulbaki.

"It was our judgment that our first case should not be a death in the UAE, to avoid any potential trouble," he said.

Donors can be Emiratis or expatriates.

"We want to break the ice, basically," said Dr Abdulbaki. "We can do deceased donor organ transplants – everybody is doing it and cooperating with us and the law now allows it, so our next organ should be from a donor in the UAE."

He is relieved the legal grey area over death has been cleared up at last.

"The existing transplant law did say that you can transfer an organ from a dead person to a live person but it didn't define death exactly, whether it's a cardiac death or brain death," he said. "What is death?

"[We had] to make sure brain death was an accepted form of death. That's why it took so long.

"Transplants didn't exist in the country until four years ago. In the past three or four years we were busy trying to get a clear definition of brain death and allow us to get organs."

While the recipient of the hospital's first successful transplant from a deceased donor recuperates, doctors are in the process of keeping the ball rolling.

"We are working on a donor registry – donor cards," Dr Abdulbaki said. "The National Transplant Committee, which is a federal committee with a mandate from the Ministry of Health, is now embarking on introducing these donor cards.

"The hope is, in the end, we have it in the National ID."

This hope could be realised by the end of this year with an opt-in model.

Before any donation, the permission for organs to be used has to be signed-off by the deceased person's family.

Once death has been confirmed by three specialist doctors, including a neurologist, organs will be removed at ministry-approved centres. A database of potential matches will then match the organ with the patient.

Although it is a step in the right direction, developments in organ transplants will move slowly.

While organ transplants from deceased donors are now allowed, doctors will at first only carry out kidney transplants, said Dr Abdulbaki. Liver transplants will be next but not in the immediate future.