PETALING JAYA: The government’s new efforts to increase the number of cadaveric organ donation have been lauded as good news for patients on the transplantation waiting list.
In support of the initiatives, National Heart Institute (IJN) clinical director of heart and lung transplantation and mechanical circulatory support services Datuk Dr Mohd Nazeri Nordin said this was the starting point for identifying more potential donors.
He added that it was a good move by the Health Ministry to identify
16 focus hospitals that will each have a unit for organ and tissue donation.
“Not only do these hospitals have a high capacity for Intensive Care Unit (ICU) patients, they also have medical personnel who are trained in identifying donors and counselling, ” said Dr Mohd Nazeri, who is a consultant cardiothoracic and transplant surgeon.
He, however, said that there was a need for the government to have a bigger budget for transplantation so that more funds were available for manpower, organ donation campaigns and clinical usage.
Dr Mohd Nazeri said there was a limited number of specialists in his discipline as not many people were keen to do complicated and high-risk surgeries.
In countries like the United Kingdom, the United States and Australia, the top transplant centres performed between 50 and 70 heart and lung transplants a year, he noted.
“We do one or two transplants a year on average at the IJN. I think the highest number was in 2011, when we did five heart and lung transplants, ” Dr Mohd Nazeri said.
Noting that the organ donation rate in Malaysia was still very low, he said this was mainly due to factors such as problems in communication, lack of awareness and failure to identify potential donors.
He added that many pledged organ donors failed to tell their family of their wish to donate their organs and tissues.
“They have to inform their immediate family members because once they’re brain dead, the family
members have to decide on their behalf.
“In most of the cases, we know that the patients wanted to donate their organs but unfortunately the family members disagreed with the donation, ” said Dr Mohd Nazeri.
National Kidney Foundation chairman Datuk Dr Zaki Morad described the Health Ministry’s plan as “good news” for end-stage kidney patients on haemodialysis.
However, he said the ministry should organise the organ donation part of the process better and also look at the transplantation side.
“Consider developing only a few centres where resources can be centralised, especially surgeons and transplant nephrologists.
“Too many centres doing transplants would not allow a centre to gain sufficient expertise and experience, ” said Dr Zaki, who is a nephrologist.
In countries with good transplant results, he said, a centre would typically do about two or three transplants a week to be considered good.
“We should also have dedicated transplant surgeons and a central laboratory with specialised pathologists and dedicated nurses, ” added Dr Zaki.
Earlier this year, the fatwa (Islamic formal ruling) on organ and tissue donation was updated to permit other organs and tissues to be donated besides the heart and cornea, which were the only two body parts previously allowed to be donated according to a 1970 national fatwa.
According to the updated fatwa issued on April 16 via Federal Territories Mufti Datuk Seri Dr Zulkifli Mohamad al-Bakri, organ and tissue donation by Muslims is permissible and encouraged.
The updated fatwa also expanded the number of permissible organs for donation to also include the kidney, liver, lungs and pancreas.
The tissues that can be donated are cornea (eyes), bones, skin and heart valve.
“However, it is prohibited to donate testis and uterus for it is closely related to lineage, ” said Zulkifli in the Bayan Linnas Series 176 on organ and tissue donation.
He added that the proposal of the revision and improvement of the fatwa regarding organ and tissue donation was presented to the Fatwa Committee on the National Council for Islamic Religious Affairs and the meeting agreed with the proposal.
“For the benefit of today’s society, we ourselves see the need to extend the concept of organ and tissue donation, ” said Zulkifli.
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