NKTI exec eyes review of kidney transplant ban for foreigners
abs-cbnnews.com | 06/02/2008 8:49 PM
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By DAVID DIZON
abs-cbnNEWS.com
For humanitarian considerations, the Philippine government should review its recent policy decision to totally ban all living non-related kidney transplants for foreigners, an official of the National Kidney Transplant Institute (NKTI) said Monday.
Dr. Reynaldo Lesaca, chief of the NKTI's Human Organ Preservation Effort office, said that while the total ban puts an immediate stop to organ trafficking in the country, the end result could be the death of many foreigners who are suffering from end-stage renal failure.
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• End stage renal disease and kidney transplantation in the Philippines
"If it were up to me, we should ban all foreigners [from getting kidney transplants] and ban non-related donors. Tapos! The problem is - you let a lot of people die. That is the consequence and it goes against the grain of developments in medical science particularly in nephrology, which shows that non-related donors can donate as long as they are not exploited but are adequately protected," he told abs-cbnNEWS.com.
He added, however, that the NKTI will continue to support the ban imposed by the Department of Health last April 29.
He said that of the eight Israeli patients exempted from the ban, only one has successfully been transplanted a kidney while the rest are still being scheduled for operation.
Health Secretary Francisco Duque imposed last April the moratorium on organ donations to foreigners to stem a thriving trade in poor Filipinos selling their own kidneys.
He said kidney transplants from Filipinos to foreigners had increased by 62 percent between 2002 and 2006. Of about 620 kidney transplants carried out in the Philippines in 2006, 63 percent involved foreign recipients, mainly from the Middle East and Europe, Duque said.
This violated an earlier health ministry rule that Filipino hospitals that carry out kidney transplants should limit foreigners to only about 10 percent of their recipients.
Duque said foreigners and middlemen who violate the ban could face up to 20 years in jail and a fine of as much as P2 million ($47,400)
700 patients on NKTI wait list
Lesaca said that before the ban, the NKTI already had 700 patients waiting for kidneys from potential donors. Of that number, half of the 700 patients on the waiting list are foreigners, he said.
He said that because of the influx of foreign patients seeking to get kidney transplants in the Philippines, the Department of Health asked the NKTI to develop a program that would conduct proper screening of non-related kidney donors in all accredited transplant centers in the country.
He admitted, however, that many foreigners are unwilling to go through the proper channels but would rather deal with the transplant surgeons directly.
"It's true that some foreigners don't fall into the program and are given preferential treatment by surgeons. Under this setup, the donor has no proper screening, no proper evaluation. The surgeons are in cahoots with the brokers and the pre-screening process is done haphazardly. You have to run after the right people, not at the program," he said.
He said that instead of banning outright kidney transplants to foreigners from non-related donors, the government should instead focus on going after brokers and transplant surgeons who engage in organ trafficking of kidneys.
No to payment, yes to 'gratuities'
Lesaca also turned down suggestions that donors should not be given gratuities for giving their organs to recipients.
"Outright payment should not be done, of course. But we do give gratuity to our donors. This is compensation for lost income during the time that he is recovering from the operation. What is wrong with giving these donors a livelihood? It's like the proverbial giving him a fish without teaching him to fish. if you give him money, before you know it, it's gone and he's back to where he was," he said.
He said that donors who register under the Kidney Foundation of the Philippines could get lifetime medical insurance under Philhealth. Some are given life insurance and even education packages for the children of the donor.
Lesaca also batted for a wider information campaign for deceased organ donation, which is provided for under Republic Act 7170 or the Organ Donation Act of 1991. Under RA 7170, organ donors can donate their organs once they are declared medically and legally-dead. Lesaca said this includes brain dead patients who only continue to live because of various apparatus that allow his other organs to function.
He said strengthening the Organ Donation Act would mean closer coordination with hospitals to ensure that recently deceased organ donors are immediately brought to transplant centers for operation. He said that in NKTI, only five to 10 percent of total kidney transplants are sourced from cadavers while the remaining 90 to 95 percent are from living donors.
Previously, the government allowed foreigners to have kidney transplants in the Philippines from living non-related Filipino donors.
From 2001 to 2006, according to Health Department statistics, there were 2,786 living non-related kidney transplants -- 266 in 2001, 310 in 2002, 420 in 2003, 470 in 2004, 630 in 2005 and 690 in 2006. The number of foreign recipients in these living non-related transplants has risen substantially -- 40 in 2002; 74 in 2003; 119 in 2004; 193 in 2005; 286 in 2006; 528 in 2007.
The Philippine Society of Nephrology has warned that the Philippines has become a world "hotspot" for human organ trafficking. Based on the group's research, Filipino donors are paid P100,000 to P150,000 (approximately $2,300-$3,440) for their kidneys.
