Transplant Law Will Save Lives, Say Doctors

Tran Dinh Thanh Lam

HO CHI MINH CITY (IPS) - The need is overwhelming, the medical technology and trained teams exist, and an organ bank was set up four years ago. Yet without a law on organ transplants, Vietnam's wealthy go abroad to shop for new organs, while thousands wait at home for legislation.

Prof Dr Le The Trung, president of the Vietnam Organ Transplant Council (VOTC), is blunt about what the absence of such legislation means. ''These patients would be saved if a law on organ transplant was adopted,'' he said.

Provisions to store organs and to carry out organ transplants exist - after all, Vietnam's doctors performed the country's first kidney transplant 11 years ago - but the benefits of such medical achievement have yet to reach those who need it most.

Article 30 of the Law of Health Protection, issued in 1989, permits patients to receive kidneys only from blood relatives. Furthermore, a government decree of January 1991 allows doctors to carry out organ transplants only for ''scientific development and health protection''. The decree does not however specify the source of the organs.

Vietnam has not legalised organ donation from the clinically dead, nor put in place any measures to monitor organ transactions.

What is in place is the infrastructure. Five hospitals - two in the capital Hanoi, two in Ho Chi Minh City and one in the central city of Hue - are equipped to have kidney transplants carried out. But thus far they have served only 106 patients, all of whom used kidneys donated by relatives.

''While each year more than 70 patients need emergency kidney transplants in Vietnam, only 5 percent actually receive them, all of them from blood relatives,'' Trung said.

Meanwhile, wealthy patients travel abroad for treatment. Each year, about 300 patients visit China for kidney transplants, for which it is estimated they pay between five and six times what they would at home (about 5,000 U.S. dollars). The rest wait for the law that would give them a chance of getting an organ donated from the clinically dead.

Hope may be on the horizon in the form of a liver transplant, the country's first, which is planned for January 2004. ''Everything would be perfect if the National Assembly approves the draft law in its year-end session,'' said Pham Manh Hung, deputy minister in the Ministry of Health.

In anticipation, the VOTC has been through months of preparation. A team of experts has been sent to Thailand to learn how to remove livers from the clinically dead and store them. Teams of liver transplant experts have also been carefully selected, with one sent to Japan for further training.

According to Minister of Health Do Nguyen Phuong, the proposed Transplant Law will regulate activities such as the registration, donation and receiving of human bodies. The law is also to contain guidelines on the control and solution of possible disputes that may arise before, during and after organ transplants.

''The Transplant Law will establish a legal framework for more human organ banks to operate,'' Hung affirmed. If indeed approval comes through for the draft law to become legislation, it will for a start make it very much easier for organ banks to stock themselves.

Since its establishment in 1999, the human organ bank in Ho Chi Minh City has received letters from 535 people who want to donate their organs after their deaths. Without a law, the bank dare not agree.

Yet senior medical professionals and proponents of the law are reminded every day of the fact that were the law in operation, lives could be saved.

Prof Dr Nguyen Kim Son, former director of the famous Vietnam-Germany Hospital in Hanoi, said that an average of five people die in the hospital every day. He emphasised that organs donated by them could save 10 other patients. ''We have wasted lots of organ, skin and bone that could be used to save others,'' Son said.

Nor is that the only source of healthy organs. Statistics from the Ministry of Health show that Vietnam's high number of dead from traffic accidents could be a key source of organs if a transplant law was approved.

The law would also enable adults - those defined as 18 years and older - to donate their organs while alive or after their deaths. In return, donors and those pledging their organs would be entitled to free or reduced-rate health check-ups.

The question of safeguards to prevent trafficking in organs is high on the agenda too. Some experts fear that allowing organs to be removed from the clinically brain-dead may lead to abuses, such as their illegal sale.

''The government would take strong action to fight the possible trade in human organs,'' affirmed Trinh Thi Le Tram, deputy director of the Ministry of Health's Department of Law. An article in the draft law indicates the built-in caution - surgeons performing transplants will not be included among medical groups that determine whether a patient is clinically brain-dead.

Even so, the issue is a thorny one. ''The hardest problem lies in convincing people that organs of those clinically dead can be donated while the heart is still beating,'' said Trung. He added that there is a need to educate the public that the clinically brain-dead often live for only a few hours. ''The organs of those people can save three to four others,'' he emphasised.

Copyright © 2003 IPS-Inter Press Service.

This article posted November 15, 2003.