No plan to allow altruistic kidney donation in Brunei
BANDAR SERI BEGAWAN
KIDNEY transplants in Brunei will remain limited to immediate family members, said the head of Nephrology Services at the Renal Services Department.
Associate Professor Dr Jackson Tan said the Ministry of Health (MoH) currently does not have plans to allow altruistic donors to give away their kidneys, highlighting that kidney transplants between genetically related donors and recipients typically produce higher compatibility.
He added that enabling genetically unrelated donors to undergo kidney transplants could also give rise to unethical practices such as the commercialisation of organs.
“To be fair, altruistic transplantation is not that common in this part of the world. You need to have strong laws to protect people who are vulnerable, because you are opening up to lots of exploitation if the law is not strong enough to protect these people,” said the head.
In a recent interview, he explained the government’s decision to limit kidney donors to immediate family members were to ensure that kidney transplants were “more ethical”.
“Why we want to deter commercialisation is because people who donate and are at a very disadvantaged position, later in life they may not be as healthy as they won’t have enough money to maintain their healthcare if they sell their kidney,” he said.
According to the World Health Organisation (WHO), kidney transplant is generally accepted as the best treatment both for quality of life and cost effectiveness.
The organisation also acknowledged the risk of exploitation, stating “the welfare of the live kidney donor is largely neglected in schemes where disadvantaged individuals are exploited and encouraged to sell their kidneys”.
Although kidney transplants can be legally performed between immediate family members, Dr Tan noted that “not everyone is suitable” for the operation.
“Age is an important factor, because the older you are the less likely you are to be fit. We’re not just looking at the compatibility of the kidney, but we are looking at how your body can respond, how strong your heart is and how your blood vessels are,” he said.
If the donor and recipient were deemed unsuitable to withstand the effects of an operation, he said a kidney transplant could be too risky for their health.
“Even if you put a brand new kidney in, if those organs are not good enough to support the kidney, then your kidney is still going to fail,” he said, noting that the operation is a very complex procedure which requires a high level of planning.
Dr Tan said that one of the long-term objectives for MoH is to do more kidney transplants to reduce the number of patients on dialysis treatment.
“There are more patients on dialysis nowadays. It’s not just a problem in Brunei, but also worldwide. It’s very important to get the public to be aware that if they want to avoid kidney disease, they need to be more proactive with their own health,” he said.
He emphasised that people should be more responsible for their own health and to make sure they detect medical problems at a very early stage by doing health checks.
Official statistics recorded 698 end-stage kidney disease patients last year, marking an increase from 620 in 2012. The vast majority of kidney patients are receiving dialysis treatment, while only 5.5 per cent have undergone kidney transplant.
Brunei’s first kidney transplant was performed in 2013, followed by the second local kidney transplant in 2014.
Health Minister Yang Berhormat Pehin Orang Kaya Johan Pahlawan Dato Seri Setia Hj Adanan Begawan Pehin Siraja Khatib Dato Seri Setia Hj Mohd Yusof last week said the increasing number of kidney patients has taken a toll on healthcare resources, the patients’ families and community.
The government reportedly spent $15.1 million on dialysis treatment and another $8 million on medication last year.
The Brunei Times