SEREMBAN: More than 20,000 people in Malaysia are waiting for donor organs, particularly kidneys.
The queue keeps growing longer because every year there are merely about 30 cases of organ and tissue donations from those who have already died, while a live donor can only give one kidney or part of his liver to a close family member.
To tackle this mismatch, the Health Ministry is revamping how it runs its organ and tissue procurement services.
The plan includes reactivating two national bodies that deal with organ donation and transplant policies, refining the role of the centre in Hospital Kuala Lumpur (HKL) that coordinates organ and tissue procurement in the country and setting up organ procurement units in 16 focus hospitals.
In a recent circular, health director-general Datuk Dr Noor Hisham Abdullah said the number of cadaveric organ and tissue donations in Malaysia was lower than that of developed countries.
He added that there was a pressing need for new initiatives to address the issue.
The focus hospitals, which all have intensive care units, include the largest government hospitals in every state except Perlis.
HKL is on the list as well, and Selangor has four focus hospitals – Sungai Buloh Hospital, Serdang Hospital, Tengku Ampuan Rahimah Klang Hospital and Selayang Hospital.
Another change is the shutting down of the ministry’s seven regional transplant resource centres.
“The seven regional centres will be closed as they mainly cater to the hospital they are based in and mostly carry out promotional activities, ” said Dr Noor Hisham.
“The 16 focus hospitals will now set up their own organ procurement units that will be responsible for identifying potential tissue and organ donors.”
The regional centres are in Penang Hospital (northern region), Sultanah Aminah (southern), Queen Elizabeth (Sabah), Sarawak General (Sarawak), Tengku Ampuan Afzan (east coast 1), Sultanah Nur Zahirah (east coast 2) and Raja Permaisuri Bainun (central).
The new teams in the focus hospitals will have full-time medical officers.
A key task for them is to detect potential organ and tissue donors from patients who have been declared brain dead or who have suffered cardiac-related deaths.
“They are also to monitor cases at the intensive care unit, including for neuro and paediatrics, coronary care unit, emergency department and forensic departments to identify potential cases, ” said Dr Noor Hisham.
All state health directors must ensure there is a full-time coordinator for organ and tissue donation at 26 other government hospitals with specialist services in the states.
“Similarly, the hospital directors must also ensure that a doctor is appointed full-time as a transplantation coordinator for organ and tissue transplant at these 26 hospitals, ” Dr Noor Hisham said, adding that these hospitals should also have their own tissue and organ procurement teams.
On the reactivated 34-member National Transplantation Council (NTC), Dr Noor Hisham said its terms of reference included deciding the direction and policies of the country’s organ and tissue transplant services.
The NTC will have representatives from universities, the Malay-sian Society of Transplantation, Association of Private Hospitals Malaysia, Malaysian Medical Association, Academy of Medicine Malaysia, Malaysian Islamic Development Department (Jakim) and Institute of Islamic Under-standing Malaysia (Ikim).
The non-Muslim religious bodies will be represented on the council as well.
“The NTC will be responsible for monitoring the development and achievements of our national organ and tissue transplant services.
“It will also ensure that the transplantation practices in Malaysia have high standards and ethics, ” added Dr Noor Hisham.
The appointment of the NTC members will be for two years.
Dr Noor Hisham said the ministry had also decided to reactivate and strengthen the National Trans-plantation Technical Committee (NTTC), whose job includes making recommendations on policy matters to the NTC.
The NTTC will be chaired by the health deputy director-general and will include all state health directors.
“The NTTC will be required to set up expert committees on training, quality and accreditation, laws and ethics as well as planning and development of services.
“It will then make the necessary recommendations to the ministry, ” he added.
The National Transplant Resource Centre based in HKL will be renamed the National Transplant Centre, which will coordinate all organ and tissue donations upon the death of donors.
The centre will also be responsible for arranging the logistics with commercial airlines, the Royal Malaysian Air Force, the police, airport security, medical and transplant teams.
Dr Noor Hisham said all states would be required to set up their own transplantation technical committees chaired by the respective health directors.
He added that each state director would have to submit a preliminary report on the implementation ofthe new initiatives within two months.