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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 Dom√≠nguez-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.

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