OTGV #26 - Human Organ Transplant Act (HOTA)
Broadcast Date: 27/01/03
Organ transplant isn't in the realm of science fiction anymore.
In fact, it is done with such regularity around the world that the problem is the shortage of transplant organs.
Last year, the Slim 10 incidents worldwide highlighted the dire need to increase the supply of organs available for transplant.
Hi welcome to On the Grapevine with me Chong Ching Liang.
This week I look at the Health Ministry move to re-tool the Human Organ Transplant Act or HOTA.
Minister of State for Health Balaji Sadasivan explains why now.
"The Human Organ Transplant Act was enacted about 15 years ago and it has served us very well with regards to transplantation. It has allowed us to increase transplantation for patients with kidney failures. But over the last 15 years, there have been considerable progress in the field of transplantation surgery, and also the public have understood and have accepted transplantation surgery as a form of treatment."
Under the present HOTA (circa 2003), only the kidneys from accident victims can be used.
With the proposed revision, liver and corneas will be added to the list and in addition, deaths from non-accident causes can also be used.
But this doesn't mean a floodgate will open, allowing all kidney or liver failure patients to get the vital organ they need.
Health Ministry's Director of Medical Services Tan Chorh Chuan.
"What are the things that make someone not suitable as a donor. Generally if their medical condition affect their organs like the liver and the kidneys to the degree that it is not going to be very useful for the transplantation and the other is that say they've got infections because if they have infections, this may carry over to the transplant process. So many of the conditions, the medical situations do not allow these organs to be optimally used for transplantation."
Even with the new revisions, there will be only 12 more donors per year.
12's the average number of brain dead patients from non-accident causes.
So the prioritising of giving younger patients kidneys over the senior citizens may not be changed.
Singapore General Hospital's principal investigator in renal transplantation, Dr Vathsala.
"Well, as you see we have a huge backlog of people who are within the age limit who are actually very, very fit to receive a transplant. We have 666 patients as of now and it will take a lot more kidneys to change the actual criteria. But certainly people will wait shorter periods, we think more people will get transplanted within a year, so that means they wait less. And if they wait less, then they have a reduced burden of dialysis. The debt on dialysis will be lower, so I think there are a lot of advantages."
Dr Prabhakaran of the National University Hospital's Liver Transplant Programme also gives a good prognosis of the proposed changes.
"It gives new hope to more than 12 patients who might get an organ because one liver donor can potentially save two lives. A liver can be split to a child and an adult. So if you have 12 new donors because of the new regulations and assuming that we can only get good livers from only 6 patients Then you can potentially save 12!"
But the revisions to HOTA will not include heart or lungs as the transplantation of these organs are still fairly experimental.
Dr Balaji as to why heart isn't included.
"Why are hearts not included? I think we want to go at a step by step process. we've had only kidneys in HOTA and moving from kidneys to liver is one step. Liver transplantation is much more established than heart transplantation. Possibly at some point in the future, we will have to look at cardiac transplantation."
Organ transplant, like death is often not openly discussed in Singapore.
In fact, one may intentionally shy from such thoughts.
So should the Health Ministry be the one to push across the donations of other organs like hearts and lungs as well?
Health Ministry’s Professor Tan explains why public policy makers need to thread carefully.
"It's trying to put out a balance approach to put out something which we think meets the professional needs because right now ,it's really the kidney failure and liver failure patients who are in a sense the most needy in terms of the numbers and the severity of impact. And also cornea because although it is not life saving, it's sight saving. So really it's trying to strike a balance. Present something that will meet our need and yet in a sense will not put people off."
Last year, Ms Rajah died from liver failure arising from Slim 10.
Dr Balaji explains why distant relatives are subjected to more scrutiny.
"Basically if you are not related, then what is important will be a psychological assessment, make sure you know what you are doing and to make sure you know all the risks that are involved. If that's done and there does not appear to be any financial inducement or organ trading, then the approval will be very quick. But with regulations that we draw up, we hope the process will be much clearer to every one."
The Health Ministry says this additional layer of bureaucracy is necessary because there needs to be checks and balances to prevent organ trading.
What do you think?
Provide your feedback to the Health Ministry in one of its public forum.
The first such forum is on the 29th of this month.
You can also forward your thoughts to Health Ministry via e-mail at MOH_HOTA@moh.gov.sg
or via fax at 6325-1686
This is Chong Ching Liang for Newsradio 938.
================================
Related Links:
Newsradio938
http://newsradio.mediacorpradio.com
Health Ministry's FAQ on HOTA
http://www.moh.gov.sg/corp/systems/organ/hota/faqs.do
National Kidney Foundation Website on Organ Donation on Laws and Policies
http://www.thegift.org.sg/why_organ_donation/policies_laws.html
National University Hospital Liver Transplant Programme
http://www.nuh.com.sg/sitemap.html
Organ transplant isn't in the realm of science fiction anymore.
In fact, it is done with such regularity around the world that the problem is the shortage of transplant organs.
Last year, the Slim 10 incidents worldwide highlighted the dire need to increase the supply of organs available for transplant.
Hi welcome to On the Grapevine with me Chong Ching Liang.
This week I look at the Health Ministry move to re-tool the Human Organ Transplant Act or HOTA.
Minister of State for Health Balaji Sadasivan explains why now.
"The Human Organ Transplant Act was enacted about 15 years ago and it has served us very well with regards to transplantation. It has allowed us to increase transplantation for patients with kidney failures. But over the last 15 years, there have been considerable progress in the field of transplantation surgery, and also the public have understood and have accepted transplantation surgery as a form of treatment."
Under the present HOTA (circa 2003), only the kidneys from accident victims can be used.
With the proposed revision, liver and corneas will be added to the list and in addition, deaths from non-accident causes can also be used.
But this doesn't mean a floodgate will open, allowing all kidney or liver failure patients to get the vital organ they need.
Health Ministry's Director of Medical Services Tan Chorh Chuan.
"What are the things that make someone not suitable as a donor. Generally if their medical condition affect their organs like the liver and the kidneys to the degree that it is not going to be very useful for the transplantation and the other is that say they've got infections because if they have infections, this may carry over to the transplant process. So many of the conditions, the medical situations do not allow these organs to be optimally used for transplantation."
Even with the new revisions, there will be only 12 more donors per year.
12's the average number of brain dead patients from non-accident causes.
So the prioritising of giving younger patients kidneys over the senior citizens may not be changed.
Singapore General Hospital's principal investigator in renal transplantation, Dr Vathsala.
"Well, as you see we have a huge backlog of people who are within the age limit who are actually very, very fit to receive a transplant. We have 666 patients as of now and it will take a lot more kidneys to change the actual criteria. But certainly people will wait shorter periods, we think more people will get transplanted within a year, so that means they wait less. And if they wait less, then they have a reduced burden of dialysis. The debt on dialysis will be lower, so I think there are a lot of advantages."
Dr Prabhakaran of the National University Hospital's Liver Transplant Programme also gives a good prognosis of the proposed changes.
"It gives new hope to more than 12 patients who might get an organ because one liver donor can potentially save two lives. A liver can be split to a child and an adult. So if you have 12 new donors because of the new regulations and assuming that we can only get good livers from only 6 patients Then you can potentially save 12!"
But the revisions to HOTA will not include heart or lungs as the transplantation of these organs are still fairly experimental.
Dr Balaji as to why heart isn't included.
"Why are hearts not included? I think we want to go at a step by step process. we've had only kidneys in HOTA and moving from kidneys to liver is one step. Liver transplantation is much more established than heart transplantation. Possibly at some point in the future, we will have to look at cardiac transplantation."
Organ transplant, like death is often not openly discussed in Singapore.
In fact, one may intentionally shy from such thoughts.
So should the Health Ministry be the one to push across the donations of other organs like hearts and lungs as well?
Health Ministry’s Professor Tan explains why public policy makers need to thread carefully.
"It's trying to put out a balance approach to put out something which we think meets the professional needs because right now ,it's really the kidney failure and liver failure patients who are in a sense the most needy in terms of the numbers and the severity of impact. And also cornea because although it is not life saving, it's sight saving. So really it's trying to strike a balance. Present something that will meet our need and yet in a sense will not put people off."
Last year, Ms Rajah died from liver failure arising from Slim 10.
Dr Balaji explains why distant relatives are subjected to more scrutiny.
"Basically if you are not related, then what is important will be a psychological assessment, make sure you know what you are doing and to make sure you know all the risks that are involved. If that's done and there does not appear to be any financial inducement or organ trading, then the approval will be very quick. But with regulations that we draw up, we hope the process will be much clearer to every one."
The Health Ministry says this additional layer of bureaucracy is necessary because there needs to be checks and balances to prevent organ trading.
What do you think?
Provide your feedback to the Health Ministry in one of its public forum.
The first such forum is on the 29th of this month.
You can also forward your thoughts to Health Ministry via e-mail at MOH_HOTA@moh.gov.sg
or via fax at 6325-1686
This is Chong Ching Liang for Newsradio 938.
================================
Related Links:
Newsradio938
http://newsradio.mediacorpradio.com
Health Ministry's FAQ on HOTA
http://www.moh.gov.sg/corp/systems/organ/hota/faqs.do
National Kidney Foundation Website on Organ Donation on Laws and Policies
http://www.thegift.org.sg/why_organ_donation/policies_laws.html
National University Hospital Liver Transplant Programme
http://www.nuh.com.sg/sitemap.html
posted by CHONG Ching-liang | 5:39 PM
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