Organ Transplant Law: Assessing compatibility with the right to health

    India law report

    The Vidhi Centre for Legal Policy has published a report on their assessment of the Organ Transplant Law’s compatibility with the Right to Health in India. Though the Transplantation of Human Organs and Tissues Act, 1994 regulates organ transplants and bans the commercial trade in organs and tissues, instances of kidney rackets and illegal trade is still being reported. The comprehensive report assesses the functioning of the Act and set recommendations to legislative and policy change. Recommendations includes the harmonisation of the definition of 'brain death' across different laws and amending the Act to ensure that victims of human trafficking are not treated as offenders.

    The report can be downloaded here.

    Towards Improving the Transfer of Care of Kidney Transplant Recipients


    J. S. Gill, A. J. Wright, F. L. Delmonico and K. A. Newell

    Article first published online: 25 July 2016, doi: 10.1111/ajt.13997

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    Abstract

    Kidney transplant recipients require specialized medical care and may be at risk for adverse health outcomes when their care is transferred. This document provides opinion-based recommendations to facilitate safe and efficient transfers of care for kidney transplant recipients including minimizing the risk of rejection, avoidance of medication errors, ensuring patient access to immunosuppressant medications, avoidance of lapses in health insurance coverage, and communication of risks of donor disease transmission. The document summarizes information to be included in a medical transfer document and includes suggestions to help the patient establish an optimal therapeutic relationship with their new transplant care team. The document is intended as a starting point towards standardization of transfers of care involving kidney transplant recipients.

     

    Full text available here from the American Journal of Transplantation

    Financial Incompatibility and Paired Kidney Exchange:Walking a Tightrope or Blazing a Trail?

    A. C. Wiseman1, and J. S. Gill


    AJT logo

    Epub; 7 December 2016

    Editorial:

    In this issue, Rees et al advance a novel strategy to increase living donor kidney transplantation through kidney paired exchange (KPE). Global kidney exchange (GKE) proposes the use of biologically compatible but “financially incompatible” living donors and recipients from an underserved country to increase KPE in the United States. The health care savings generated by removing US patients from dialysis would be used to cover the cost of transplantation and posttransplant care including immunosuppressant drugs for the recipient in their home country for a period of 5 years in exchange for the compatible pair’s participation in KPE. The report describes the first application of GKE in which an indigent biologically compatible married couple in the Philippines who could not afford to proceed with living donor kidney transplantation was brought to the United States where the wife’s donation of a kidney ultimately facilitated KPE transplants for 10 American patients as well as for her husband.

    While we applaud Rees et al’s efforts to advance a novel approach to increase living donor kidney transplantation, there are numerous considerations that require equipoise, including the legality of this new definition of “financial incompatibility.” The Charlie Norwood Act amended the National Organ Transplant Act (NOTA) to allow human organ paired donation between biologically incompatible living donors and recipients. The use of compatible donors and recipients on the basis of financial incompatibility may not be encompassed in current interpretation of NOTA. While the authors offer a thoughtful rebuttal to this consideration, expansion of GKE would probably require amendment of NOTA.The risk of exploitation (real or potential) in GKE is a significant concern...

    Read the full editorial here

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