PESHAWAR: Khyber Pakhtunkhwa Medical Transplantation Regulatory Authority has allowed organ donation by non-relatives to discourage illegal transplants in the province.

MTRA administrator Prof Asif Malik said that the decision was taken to ensure that people got donation of organs from non-relatives on voluntary basis after fulfillment of conditionalities as per law and put brakes on commercial donation.

He said that the move was meant to benefit the patients, who didn’t find healthy donors in their close family members due to which their health condition deteriorated. He added that the move was aimed at benefiting many patients, who didn’t find donors in close family members to undergo renal transplants.

“However, the recipients should go for blood-related donors as their kidneys are matched easily and outcomes are much better than those of non-relatives,” he said.

MTRA move meant to discourage illegal transplantations

Prof Asif, a renal transplant surgeon, said that there was foolproof mechanism through which donors and recipients would prove their closeness. He said that it was not possible that the donor belonged to Punjab and the recipient belonged to Khyber Pakhtunkhwa.

In a letter sent to heads of recognised hospitals and chairpersons of transplant evaluation committees (TECs), the MTRA administrator said that in response to increasing number of unrelated organ donation cases being submitted for issuance of no objection certificate, the Authority sought clarification from law department regarding certain provisions of Khyber Pakhtunkhwa Medical Transplantation Regulatory Authority Act, 2014, and Khyber Pakhtunkhwa Medical Transplantation Regulatory Rules, 2017.

The primary concern revolves around organ donations involving individuals, who are neither close blood relatives nor related to the recipient. This step is being taken to ensure full compliance with the established legal framework and to provide interpretative clarity on these critical aspects of organ donation and transplantation.

Such clarification is deemed essential to uphold the integrity of the process and to address any potential concerns about ethical and legal violations including prevention of unlawful practices such as organ trafficking.

According to law department, “close blood relative” means parent, son, daughter, sister, brother and includes spouse. The word non-close blood relative has not been defined properly in Khyber Pakhtunkhwa Medical Transplantation Regulatory Authority Rules, 2017, and there is an ambiguity in its definition.

However, by plain dictionary meaning and by placing reliance upon the letter issued by Ministry of Health, Islamabad in March 2008, the true grandfather, how high soever, true grandmother, how high soever, mother-in-law and father-in-law, wife’s daughter, husband’s son or their grandsons and granddaughters, son’s wife, daughter’s husband including stepmother and father, son’s sons, son’s daughters and daughter’s children, consanguine brother and sister, uterine brother or sister, full brother’s son and consanguine brother’s son, full paternal uncle and consanguine paternal uncle, full brother’s daughters and their descendants and consanguine brother’s daughters and their descendants are included in non-close blood relatives.

Additionally, uterine brother’s children and their descendants, children of sisters (full consanguine and uterine how low soever) and their descendants, full paternal uncle’s daughters and their descendants, consanguine paternal uncle’s daughters and their descendants, uterine paternal uncles, their children and their descendants, paternal aunts (full consanguine and uterine), their children and their descendants and maternal uncles and aunts, their children and their descendants also come under the category of non-close blood relatives.

The MTRA’s letter said that it was pertinent to mention that law provided an exception for the grant of donation of an organ in certain special cases and circumstances. The term unrelated donor means a donor, who is neither close blood relative nor non-close blood relative.

Moreover, donation of an organ by unrelated donor can be allowed in certain special cases by strictly fulfilling the conditions including willingness of the donor, recommendation of the evaluation committee, the case of the recipient is having risk of death and his life can be saved by such transplantation and donation must be voluntary and free from consideration.

The relevant TECs have been directed to follow the instructions and adhere to the criteria laid down in the law and its rules in letter and spirit while evaluating such organ donations. Presently, renal and corneal transplants are being conducted in Khyber Pakhtunkhwa.

Published in Dawn, October 21th, 2024