The New Paper
14 Aug 2008
Organ trading model in next 1 to 3 years
But Health Minister Khaw Boon Wan proposes that the model, only for kidneys, be managed by independent body using strict screening.
By Ng Wan Ching
SINGAPORE may have an acceptable model of organ trading in the next one to three years. While it may not be an ideal solution to the shortage of donor organs here, it cannot be ignored either.
That was how Health Minister Khaw Boon Wan characterised his dilemma in a closed-door dialogue held last month with 30 professionals. The dialogue, organised by the People's Action Party's (PAP) Women's Wing, was reported in the July/August issue of Petir, the PAP magazine.
Mr Khaw said that while the debate rages on, patients are dying and the poor are being exploited to part with their kidneys at a low price. Hence, he cannot ignore it.
'If we don't do anything about it, we will be guilty ourselves,' he said.
STOPPING EXPLOITATION
In the clearest picture yet of how an organ trading system might work here, Mr Khaw said this was how he would do it:
1. Restrict trading to kidneys only, as trading in other organs creates other problems or involves a higher transplant risk to donors.
2. Eliminate a direct transaction between the donor and the patient by letting an independent, professionally-run third party, the kidney bank, manage the donor pool and match the transplants.
3. Require stringent screening, full risk disclosure and communication with donors and their families, to ensure that only healthy donors are selected and their decisions fully informed.
The third party (the kidney bank) will also safeguard the welfare, health and interests of donors by providing pre- and post-surgery care.
Petir reported Mr Khaw as saying that this would be the greatest value of legalising kidney trading - to stop the exploitation of the poor and ignorant, who do not know the full value of their kidneys. For the best possible outcome, he added that matching should be based only on clinical criteria, not dollars and cents.
He suggested that a way to subsidise poor patients' access to kidneys is by requiring those who can afford it to pay the international price to the kidney bank - 'the Robin Hood principle where one rich patient can possibly support transplants for five poor patients'.
'This will address the current problem of black market trading where the poor can only be donors but not possible recipients,' he said.
The audience asked if more could be done to promote altruistic donations.
Mr Khaw said that compared to Sweden, where family members will readily offer their kidneys for transplants to their loved ones, Singapore's altruistic transplant rate is 'shameful'. There are hundreds of patients on the waiting list, but altruistic donations from family members number only in the dozens.
Mr Khaw said that currently, each year, about 200 Singaporeans join the pool of patients who can potentially benefit from a kidney transplant.
Of these, 50 will get one from deceased donors under the Human Organ Transplant Act (Hota); another 30 will receive a donation from a relative and 20 will go abroad for a transplant. To help the remaining 100, the Ministry of Health will propose that Parliament remove the Hota age limit for deceased donors, now set at 60 years.
The MOH will also explore matching a donor whose tissue is incompatible with the intended recipient's with another donor-patient pair in a similar situation.
These initiatives will raise the kidney transplant rate by another 30 to 40 patients a year. But that still leaves about 60 patients without a transplant option.
While altruistic donation is the way to go, he said that the door should also be kept ajar for some limited transactions to take place. His estimated time frame is to have an acceptable model of organ trading in the next one to three years.
14 Aug 2008
Organ trading model in next 1 to 3 years
But Health Minister Khaw Boon Wan proposes that the model, only for kidneys, be managed by independent body using strict screening.
By Ng Wan Ching
SINGAPORE may have an acceptable model of organ trading in the next one to three years. While it may not be an ideal solution to the shortage of donor organs here, it cannot be ignored either.
That was how Health Minister Khaw Boon Wan characterised his dilemma in a closed-door dialogue held last month with 30 professionals. The dialogue, organised by the People's Action Party's (PAP) Women's Wing, was reported in the July/August issue of Petir, the PAP magazine.
Mr Khaw said that while the debate rages on, patients are dying and the poor are being exploited to part with their kidneys at a low price. Hence, he cannot ignore it.
'If we don't do anything about it, we will be guilty ourselves,' he said.
STOPPING EXPLOITATION
In the clearest picture yet of how an organ trading system might work here, Mr Khaw said this was how he would do it:
1. Restrict trading to kidneys only, as trading in other organs creates other problems or involves a higher transplant risk to donors.
2. Eliminate a direct transaction between the donor and the patient by letting an independent, professionally-run third party, the kidney bank, manage the donor pool and match the transplants.
3. Require stringent screening, full risk disclosure and communication with donors and their families, to ensure that only healthy donors are selected and their decisions fully informed.
The third party (the kidney bank) will also safeguard the welfare, health and interests of donors by providing pre- and post-surgery care.
Petir reported Mr Khaw as saying that this would be the greatest value of legalising kidney trading - to stop the exploitation of the poor and ignorant, who do not know the full value of their kidneys. For the best possible outcome, he added that matching should be based only on clinical criteria, not dollars and cents.
He suggested that a way to subsidise poor patients' access to kidneys is by requiring those who can afford it to pay the international price to the kidney bank - 'the Robin Hood principle where one rich patient can possibly support transplants for five poor patients'.
'This will address the current problem of black market trading where the poor can only be donors but not possible recipients,' he said.
The audience asked if more could be done to promote altruistic donations.
Mr Khaw said that compared to Sweden, where family members will readily offer their kidneys for transplants to their loved ones, Singapore's altruistic transplant rate is 'shameful'. There are hundreds of patients on the waiting list, but altruistic donations from family members number only in the dozens.
Mr Khaw said that currently, each year, about 200 Singaporeans join the pool of patients who can potentially benefit from a kidney transplant.
Of these, 50 will get one from deceased donors under the Human Organ Transplant Act (Hota); another 30 will receive a donation from a relative and 20 will go abroad for a transplant. To help the remaining 100, the Ministry of Health will propose that Parliament remove the Hota age limit for deceased donors, now set at 60 years.
The MOH will also explore matching a donor whose tissue is incompatible with the intended recipient's with another donor-patient pair in a similar situation.
These initiatives will raise the kidney transplant rate by another 30 to 40 patients a year. But that still leaves about 60 patients without a transplant option.
While altruistic donation is the way to go, he said that the door should also be kept ajar for some limited transactions to take place. His estimated time frame is to have an acceptable model of organ trading in the next one to three years.
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