Sat, Dec 06, 2003 - Page 2 News List

Organ-transplant system allocations start in March

CHECK-UPS Kinks in the registration and donation system still have to be worked out to ensure the procurement process is equitable and transparent


The newly established Taiwan Organ Registry and Sharing Center (TORSC) will begin allocating donated organs in early March despite contention over current regulations, according to Department of Health officials.

"The TORSC was contracted by the Department of Health in accordance with the stipulations of Article 10 of The Organ Transplant Law (人體器官移植條例) in an effort to make the allocation more fair, transparent and efficient," said Hsueh Jui-yuan (薛瑞元), deputy director of the Bureau of Medical Affairs, explaining that the registry was established with the intent of creating Taiwan's first nationwide organ-donation network.

Hsueh said that negotiations among transplantation hospitals had resulted in an agreement to register all heart, liver, lung and kidney donors and wait-listed potential recipients on an online data network.

The Organ Transplant Law man-dates that hospitals which fail to register organ donors and recipients be fined between NT$30,000 and NT$50,000.

"The organ database is basically to make the entire organ donation and procurement process more transparent and fair. Currently, some people even go to China to procure organs for transplan-tation," said Ko Wen-je (柯文哲), the National Taiwan University Hospital surgeon overseeing the establishment of the database.

"Organ and patient registration officially began on Dec. 1, but organ allocation will not begin until March. This gives doctors time to make revisions to the current organ-sharing regulations," Hsueh said.

However, Ko admits that those regulations are a messy and controversial issue among doctors. Geographic location, the severity of a patient's condition and a hospital's technical expertise are all brought into play in the process of matching the organs available with those who need them.

"The regulations are quite complicated, and different for each organ. While the heart, liver, and lungs are given in accordance with the severity of a patient's condi-tion, kidneys are distributed by geographic area. It would be unfair for organs donated in southern Taiwan to all be given to patients in northern Taiwan just because there are more transplantation hospitals in Taipei," Ko said.

"Some hospitals have less experience with transplant procedures, but they might receive an organ needed for a difficult transplant operation," he said. "Right now, the only check on a hospital's surgical performance we have is post-operation checkups. If the transplantation is unsuccessful, then perhaps in the future people will avoid that hospital."

The order in which people are wait-listed is also a point of contention. According to regulations, people with Hepatitis B or C are given low rankings. If a person previously donated an organ, he or she is given priority. Children under the age of 11 also get higher rankings.

"The organ-sharing regulations were the product of a democratic voting process among doctors, so they're not actually that coherent. The regulations, as they stand, are just the results of doctors' professional opinions. There are, however, societal issues to be discussed," Ko said.

Ko emphasized that the registry needs to be backed up by organ-procurement organizations if there are to be enough organs listed to support the number of people awaiting transplants.

He said the TORSC was modeled after the US' United Network for Organ Sharing but he pointed out that the US had simultaneously established several organ-procurement organizations.

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