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    Organ Transplantation in Pakistan

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    Muhammad Khurram Shahzad
    This PPT higlights the facts about organ transplantation in Pakistan, lack of awareness and how the organs are put to sale in Pakistan. There is lack of implentation of the law against the organs selling bussiness in the country.

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    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd

    Organ Transplantation in Pakistan

    Uploaded by

    Muhammad Khurram Shahzad
    267 views12 pages
    This PPT higlights the facts about organ transplantation in Pakistan, lack of awareness and how the organs are put to sale in Pakistan. There is lack of implentation of the law against the organs selling bussiness in the country.

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    Organ transplantation in Pakistan

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    This PPT higlights the facts about organ transplantation in Pakistan, lack of awareness and how the organs are put to sale in Pakistan. There is lack of implentation of the law against the organs selling bussiness in the country.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    267 views12 pages

    Organ Transplantation in Pakistan

    Uploaded by

    Muhammad Khurram Shahzad
    This PPT higlights the facts about organ transplantation in Pakistan, lack of awareness and how the organs are put to sale in Pakistan. There is lack of implentation of the law against the organs selling bussiness in the country.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
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    Muhammad Shahzad ID: 1127032

    Shifting of Kidney Bazar from India to Pakistan Over past two decades Pakistan has become a zone of commercial renal transplantation. Dilemma of Kidney trade is confused even among medical students and young doctors and consider it Life Saving procedure.

    The organ-exporting countries Pakistan, India, South Africa, Peru, Romania, Bolivia, Brazil, and Chinaetc.

    The organ-importing countries richer European countries, Israel, United States, Canada, Australia, New Zealand, Japan and some Arab countriesetc.

    (Norm Barber, 2007 & WHO)

    Organ transplantation: Primary Treatment of End Stage Organ Failure. Benefited more than 1 million people worldwide No of pts survived for well over 25 years. Shortage of organ is a Universal Phenomenon (WHO). Kidney Transplantation is carried out in 91 countries. Organ Transplantation Global Statistic by 2005(WHO) 66000 Kidney Transplants, 21000 Liver Transplant, 6000 Heart Transplants. Shortage of organ donation has led to the organ trade A World Health Assembly resolution adopted in 2004 (WHA57.18) urges Member States to take

    Living organ Donation Living Related (first or second degree relative)- living donor gets disadvantaged- not favored e.g. renal transplantation is most common worldwide and most of debate revolve around it. Living non-related (where anybody else donates. So many issues are there when donor is unrelated. The various situations can be

    A.

    B.

    Altruistic Organ Donation: one must consider the unrelated donor who has a stable and close emotional relationship with recipient such as husband or wife. Paid Organ Donation: This is an important Ethical Issue. There are regional variations in its acceptance and practice e.g. In France it is crime. In Iran it is legal and person who sell his organ is insured and also he gets money from the donor.

    Cadaveric Transplantation: Organs for transplantation are usually obtained from living genetic relatives or from heart-beating cadavers. Unfortunately, these sources have so far been unable to keep up with demand. As a result, there are a large and steadily increasing number of potential recipients awaiting transplantation, some of whom will die before an organ can be found. Cadaveric source is beneficial in another way that it provides multi-organ donation [17]. To utilize cadaveric organs effectively, most of the

    Legislation in Pakistan regarding organ transplantation: Government efforts, supported by professional associations, civil society organizations and the media, along with World Health Organization technical assistance, have led to the development of legislation regulating this practice and curbing organ trade in conformity with international guidelines. 1979 Renal transplantation started in Pakistan in public sector hospitals using living related family donors

    1990s Renal transplantations exceeded 500 transplantations per year with first violations observed, whereby some hospitals shifted from dealing exclusively with living, related donor to unrelated, paid donors until these unethical practices accounted for more than 80% of all transplantations. Later in the decade transplantations exceeded 1000 per year 2000s Opposition to promulgating the law was sustained and commercial kidney transplantation flourished with over 1500 expatriates receiving locally procured kidneys. The Ministry of Health, supported by SIUT, media and civil society organizations, sustained its efforts to promote legislation and bring an end to these unethical practices. WHO provided the necessary technical support through its country, regional and headquarter institutions. 2004 A bill was tabled in the Pakistan Senate by a member raising the momentum for action.

    2006 The organ transplantation agenda submitted to the Cabinet in 2004 was deferred in October 2006. This action ignited an active campaign, where informed and investigative media reports and SIUTs bold and challenging technical deliberations exposed the growing unethical lucrative kidney trade. 2007 Exploitative organ transplantation led to a judicial action in July 2007, whereby the Supreme Court of Pakistan took a suo moto notice advising the Government to promulgate the transplantation law. 2007 The transplantation ordinance was promulgated in September 2007 by the President of Pakistan.

    2008 Attempts were made by the counter lobby through the Standing Committee for Health at the National Assembly to water down the law by introducing loopholes implicitly condoning organ sale and allowing expatriates to acquire kidneys for lucrative fees. These endeavours were rejected by the Standing Committees for Health and Human Rights. 2008 A case was filed before the Federal Shariat Court of Pakistan, challenging the law, whereby 12 hearing sessions were held in Islamabad, Lahore and Karachi, unanimously defeating all submitted objections and rendering all stipulated clauses of the law sustained, including the illegality of all forms of organ sale. 2009 On 23 June 2009, the Supreme Court took suo moto notice against private hospitals accused of violating the law and performing illegal transplantations, who when summoned by the court made commitments to comply with the law. 2009 On 12 November 2009, the National Assembly of Pakistan unanimously passed the bill on the recommendation of its Standing Committee on Health. 2010 On 10 February 2010, the Senate of Pakistan passed the bill. 2010 On 17 March 2010, the President of Pakistan signed the bill making it a law

    To evaluate the public health contribution of organ transplantation services, the Ministry of Health needs to establish a database, for both donors and recipients, supported by the centres providing these services. The capacity of the health system to offer dialysis to end-stage chronic renal failure needs to be strengthened, to reduce patient morbidity and improve quality of life. Moreover, the Ministry of Health should closely monitor surgical, medical and immunosuppressive protocols and establish a mandatory 2-year follow-up of donors and recipients to provide medical, emotional and psychosocial support and also evaluate the outcome of these interventions nationwide.

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