Guidelines on donation of organs in the pipeline

According to the government, it is working on the final details on kidney transplants slated for publication on June 1, this year.

At the moment, there are no liver transplants taking place in the country owing to the absence of laws and regulations governing the practice, which leads to the deaths to patients with kidney failure.

Moreover, there are no liver, kidney or cornea transfers that have been carried out, and patients are being taken to the Indian-based Apollo Hospital for the same.

Minister of Health, Community Development, Elderly, Gender and Children Ummy Mwalimu recently disclosed to the Guardian that current focus was on local surgical transplants with a view to reducing the costs of seeking such services overseas to both patients and the nation.

She was reacting to an appeal echoed by International Transplantation Network (ITN) members who met in Turkey recently and proposed the formulation of regulations on the recovery of organs from living and dead donors to transplant recipients.

The minister said currently there were no regulations or laws governing the recovery of organs from either the deceased or living donors for transplantation.

She said often times those financially able were being referred to Apollo Hospital in India to undergo kidney transplant.

“We are now preparing to handle kidney transplant cases in the country for the first time and the government is finalizing formulation of the guidelines before specific laws are formed,” she says

According to her, the cost of dialysis was enormous for a least developed country like Tanzania where resources and technology were rather limited.

She said that since renal transplant was not performed in the country and only a few patients can afford going overseas for surgery, hemodialysis was the main form of Renal Replacement Therapy (RRT) available.

The minister said as of 2015, only three public and nine private hospitals were offering hemodialysis in the country.

“All these efforts target to mitigate the cost patients as individual and nation at large incur in sending one patient overseas,” she says.

For her part, a Tanzanian advocate working with Legal Human Right Center (LHRC) Ana Henga asked the government to review its laws and regulations to allow transplants to take place in local hospitals.

She admits that the Public Health ACT of 2009 must now be amended to allow liver transplants to take place that would help to save lives.

Henga said this would be a good step that would also show the way towards amendment of the Public Health Law of 2009 and help to reduce government costs in the health sector.

However, before a final decision on the allocation of budgets towards dialysis was made efforts had to be made to invest in improved technical efficiency by cutting the enormous unit cost.

It was further explained that 75 per cent of the service providers and a considerable – but unknown – share of dialysis machines were concentrated in Dar es Salaam, the commercial capital of the country. Thus, the majority of Tanzanians have no access to dialysis services due to the high concentration in one city.

Furthermore, the majority of patients in Dar es Salaam face severe financial barriers to access dialysis services as only minorities of the population are covered by National Health Insurance Fund (NHIF) or private insurers.

Earlier, in the 4th Media Workshop on Organ Donation and Transplants held in Turkey, Tanzania and other African countries were asked to form regulations that would govern the recovery of organs from deceased or living donors and practice transplantation consistent with international standards

Having been organized by the International by International Transplant Network (ITN), it attracted participants from the media, health practitioners and officials from the ministry of Health in and outside Turkey.

In an interview with The Guardian on the sidelines of the workshop held in Istanbul, Turkey, renowned researcher and author Katayoun Najafizadeh from Iran disclosed that there was a need to amend its regulations to rescue the lives of those with organ failure.

Najafizadeh said governments in collaboration with heath care institutions, professionals and non-governmental organization should take approach actions to increase organ donation from the bodies of the deceased.

The researcher explained that once policies and procedures were in place, they are ought to be developed and implemented to maximize the number of organs available for transplantation consistent with the principles.

She however highlighted that the practice of donation and transplantation required oversight and accountability by health authorities in each country to ensure transparency and safety.

“The primary objective and transplantation policies and programs should be optimal short- and long term medical care to promote the health of both donors and recipients,” she said
Earlier in her presentation, she said brain death was an irreversible loss of brain and brainstem activities and actual these were the main organ donors.

Citing her own country, the author said most families refused to donate organs from brain dead patients.

Najafizadeh described that suspected brain dead patients were detected and evaluated for the signs of brain deaths and suitability of the organs.

According to the researcher, if the patient was suitable donor, their family was approached by the coordinator and social workers.

She said upon family consent, the patient was transferred to the Organ Procurement Unit (OPU), Intensive care Unit (ICU) of Masih Daneshvari Hospital and organs were retrieved after conformation of brain death.

Najafizadeh clarified that there are both ethical and logistic problems with mandated choice. The view of the family should be respected in organ requests, even when patient wishes are known.

Furthermore, the Public sentiment against overriding family wishes could cause low rates of pro-donation registration.

In her explanation, the researcher used to showcase different experience Iran did to achieve consistent organ donation and transplantation.

“Initially, it was not an easy task due to lack of public awareness on the importance of being an organ donor,” she said.Globally, there are millions of patients who die while waiting for organ transplants.