x Abu Dhabi, UAETuesday 23 January 2018

Transplant hope for thousands

Thousands of people could receive life-saving organs after a law is clarified so that organs from dead patients can be used in operations.

Hussanzari Muhammad Amroze, undergoes dialysis treatment at Al Qassimi hospital in Sharjah as her husband Syed watches on. She is one of more than 1,000 people across the UAE waiting for kidney transplants.
Hussanzari Muhammad Amroze, undergoes dialysis treatment at Al Qassimi hospital in Sharjah as her husband Syed watches on. She is one of more than 1,000 people across the UAE waiting for kidney transplants.

Thousands of people across the country could finally receive life-saving organ transplants after the Ministry of Health gave the go-ahead to use organs from dead donors. Although organ transplants were legalised in 1993, the law did not include a medical definition of death. That made it impossible to use organs from dead patients, who have to be kept ventilated to allow time for a suitable transplant patient to be found.

Dr Hanif Hassan, the Minister of Health, signed off this week on an appendix containing the necessary definitions and rules governing the practice. The document, released by the National Organ Transplant Committee on Sunday, allows transplants of kidneys, liver, lung, pancreas and the heart. More than 1,000 people across the UAE are waiting for kidney transplants alone. Permission for organs to be used will have to be given either in the dead person's will, or by their family.

Once death has been confirmed by three specialist doctors, including a neurologist, organs will be removed at ministry-approved centres. The appendix directs the ministry to co-ordinate with health authorities to create and regulate these centres. The move was welcomed by doctors, who have long called for a clarification of the law. Dr Mustafa Ahmed Kazim, a consultant nephrologist in Dubai, said it was a huge step, but one that needed to be backed up by the proper infrastructure.

"In Oman, the law has been in place for 10 years but it has not taken off," he said. "We don't want the same to happen here because it is badly needed. We need a proper strategy in place and we need it today." He said there were still important questions, including which patients should have priority and how donors should be registered. Sheikh Khalifa Medical City, the capital's largest public hospital, has performed 23 transplants from live donors since it set up its programme in 2008. It is currently the only hospital authorised to do them.

Dr Abrar Khan, the head of the programme, said he expected the hospital's waiting list of more than 100 to be very quickly cleared. Calling the clarification a "seminal event", he said it would take "many years" for its full impact to be felt. He estimated that the hospital would eventually be able to perform 50 kidney, 20 liver and five pancreas transplants from donors each year. The UAE has now been brought into line with other countries in the region. Egypt implemented a new organ donation law this month in an attempt to reduce the illegal organ trade. Oman, Kuwait, Iran and Saudi Arabia also allow transplants from dead patients.

Seha, which manages public hospitals in the capital, said the new rules would enable collaboration between Middle Eastern countries similar to that in Europe and North America. Dr Ashraf Elhoufi, the head of the intensive care unit at Dubai Hospital, said although the latest step was helpful, officials should not underestimate the importance of public awareness. "The hard part is getting friends and family to accept this," he said. "The awareness about brain death is just not there. Ventilator machines are left on for months, or longer. The problem will never be solved unless non-medical people understand brain-dead is dead. Without this, the programme cannot start."

There has been concern among doctors that banning transplants has pushed patients to go overseas, to receive organs from the black market. That trade now needs to be stamped out for the legal transplantation programme to work. "You cannot have both," said Dr Kazim. The appendix will come into effect when it is published in the country's official gazette. No one from the ministry was available yesterday to confirm when this would be.