A call for government accountability to achieve national self-sufficiency in organ donation and transplantation

    The Lancet, Volume 378, Issue 9800, Pages 1414 - 1418, 15 October 2011
    doi:10.1016/S0140-6736(11)61486-4

    Prof Francis L Delmonico MD , Beatriz Domínguez-Gil MD, Rafael Matesanz MD, Luc Noel MD 

    Summary

    Roughly 100 000 patients worldwide undergo organ transplantation annually, but many other patients remain on waiting lists. Transplantation rates vary substantially across countries. Affluent patients in nations with long waiting lists do not always wait for donations from within their own countries. Commercially driven transplantation, however, does not always ensure proper medical care of recipients or donors, and might lengthen waiting times for resident patients or increase the illegal and unethical purchase of organs from living donors. Governments should systematically address the needs of their countries according to a legal framework. Medical strategies to prevent end-stage organ failure must also be implemented. In view of the Madrid Resolution, the Declaration of Istanbul, and the 63rd World Health Assembly Resolution, a new paradigm of national self-sufficiency is needed. Each country or region should strive to provide a sufficient number of organs from within its own population, guided by WHO ethics principles.

    Opportunities to deter transplant tourism exist before referral for transplantation and during the workup and management of transplant candidates

    Opportunities to deter transplant tourism exist before referral for transplantation and during the workup and management of transplant candidates

    Kidney International (2011) 79, 1026–1031; doi:10.1038/ki.2010.540; published online 12 January 2011

    Jagbir Gill, Olivier Diec, David N Landsberg, Caren Rose, Olwyn Johnston, Paul A Keown and John S Gill
    Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

    Transplant tourism is a global issue, and physicians in the developed world may be in a position to actively deter this practice. To examine such opportunities, we identified 93 residents of British Columbia, Canada who had a kidney graft through tourism and determined their previous interactions with our transplant programs.

    Click here to read the full article.

    The Use of Executed Prisoners as a Source of Organ Transplants in China Must Stop


    The Use of Executed Prisoners as a Source of Organ Transplants in China Must Stop

    G.M. Danovitch, M. E. Shapiro, J. Lavee

    Abstract

    Internationally accepted ethical standards are unequivocal in their prohibition of the use of organs recovered from executed prisoners: yet this practice continues in China despite indications that Ministry of Health officials intend to end this abhorrent practice. Recently published articles on this topic emphasize the medical complications that result from liver transplantation from executed ‘donors’ but scant attention is given to the source of the organs, raising concern that the transplant community may be coming inured to unacceptable practice. Strategies to influence positive change in organ donation practice in China by the international transplant community are discussed. They include an absolutist policy whereby no clinical data from China is deemed acceptable until unacceptable donation practices end, and an incremental policy whereby clinical data is carefully evaluated for acceptability. The relative advantages and drawbacks of these strategies are discussed together with some practical suggestions for response available to individuals and the transplant community.

    Click here to read the full article.
    • ##########

    DICG Login