Organ transplant law: Cabinet approves amendment adding cousins, grandchildren to donors' list

The government has cleared an amendment to the law allowing more family members to become potential organ transplant donors.

The amended law will also require all hospitals without a specialised unit for such procedures to obtain prior approval for transplants.

The draft of the ‘Organ Transplantation Act (Amendment) 2017’ was granted a final approval on Monday during a Cabinet meeting chaired by Prime Minister Sheikh Hasina.

The amendment approves of grandparents, grandchildren and first cousins as potential donors, said Additional Cabinet Secretary Md Ashraf Shameem.

The existing law allows only siblings, children, parents, spouses, and blood-related aunts and uncles to donate organs.

"No hospitals can perform organ transplant procedures without securing an approval from the government, except for the state-run ones with specialised units for it," Shameem told the reporters after the meeting.

Once the amendment goes into effect, it will allow transplant of any transplantable organs besides kidneys, heart, lungs, intestines, liver, pancreas, bone, bone marrow, eyes, skin and tissue, according to Shameem.

The government moved to amend the 1999 law following a High Court order of 2011.       

Additional Secretary Shameem said the amendment aims to develop medical services in conformity with the progresses in medical science.

"It will also stop illegal businesses in and smuggling of organs," he added.

Rules for donation

Shameem said any healthy person with normal intelligence can donate organs to relatives permitted by the law if there is no fear that the normal life of the donors may be hampered.

Donors of eyes and bone marrow do not need to be close relatives of the receivers.

The additional secretary said any legal heir can permit donation of any organ from a person declared brain dead.

The corresponding hospital can also do the same in such cases if no one claims succession of the potential donor within 24 hours of drain death, he added.     

The official said the declaration of brain death must come from a committee of at least three specialist professors or associate professors of medicine or critical care medicine, neurology, and anaesthesiology.

But no one of the committee or their relatives can be involved with the transplant.

The additional secretary said the law details the conditions in which doctors cannot declare brain death.

Criteria of donor and recipient

According to the amended law, no organ other than eyes and bone marrow can be taken from any brain dead person hey are aged below 2 years or above 65 years. 

No organ can be taken from a person if he or she forbids it before death. 

And living donors must be aged between 18 and 65.

Shameem said people aged between 15 and 50 will be prioritised as recipients but this restriction will not apply for the transplant of cornea.

He added no organ other than eyes and bone marrow can be taken from a person who has been test positive for HIV, HBSAg or HCV.

Boards

The changed law stipulates the formation of a medical board headed by a surgeon with the rank of a professor at the corresponding hospital for organ transplantation.

An anaesthesiologist of at least associate professor rank and a director or a doctor will be members of the board.

The law also stipulates the formation of a board to attest and assist the organ transplantations.

An officer of the Directorate General of Health Services with the rank of at least a deputy director will head the board.   

The government will also form an 11-strong cadaveric national committee with the vice chancellor of Bangabandhu Sheikh Mujib Medical University as its head to oversee collection of organs from brain-dead people.

Offences and penalties

Providing wrong information on close relatives or encouraging or threatening someone to give wrong information will be considered offence under the law.

The punishment for such offence is maximum two-year imprisonment or up to Tk 500,000 fines or both.

The punishment for other offences under the law is maximum three-year imprisonment or up to Tk 1 million fines or both.

If any doctor violates the law, they will lose registration.

The additional cabinet secretary also said if any hospital or clinic violates the law, its owner, director and manager or whatever designation they have will be considered offenders unless they are able to prove that the crimes were committed beyond their knowledge and they tried their best to stop those.

The hospital will lose permission for organ transplantation and face fines for violating the law.

In the original law, the maximum punishment was seven years in jail and minimum three years of imprisonment or Tk 300,000 fine or both.

Asked whether the amendment has reduced the punishment, Shameem said, "The punishments were mentioned in general in the previous law. Now those have been specified."

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