CAIRO: “Despite the fact that organ transplants have been successfully carried out for decades, there still remain many ethical and organizational angles to the issue, said Professor Francois-rene Pruvot, from the University of Lille in France said during a lecture at the French Cultural Center on Monday.
Pruvot spoke primarily about the French model while highlighting the history, status quo and the future of organ transplant worldwide.
Finding a suitable donor is not as simple as collecting a prescription from a local pharmacy.
In Egypt, for instance, the poor are fully prepared to sell their organs, oblivious of the consequences to their health.
Pruvot was also in Cairo to discuss the difficulties and possibilities of cooperation in the field with high-ranking Egyptian health officials at Kasr El Aini.
The French specialist said that some 4,500 transplants were carried out in France in 2006. Of these, 2,700 were kidney transplants, 1,000 liver transplants, 200 lungs transplants, 360 heart transplants and 100 pancreas transplants.
“Only 10 percent of these organs came from living donors, remarked Pruvot, stressing that the main problem with this kind of treatment is the availability of organs.
As health authorities are strict in enforcing restrictions, the concern worldwide remains focused on using the power of persuasion to raise awareness that donations are a form of charity.
Pruvot described how even in Europe the majority are still reluctant when it comes to cadaveric transplants, that is, transferring organs from the dead to the living. This type of donation is common in Spain, France, Italy, England and Germany. In Spain living-living donations number 30 cases per million, a rate that reflects the Spaniards’ benevolence.
In the US, however, donations go equally in both directions. In Asia it’s predominantly living-living donations.
“It’s been taken for granted that where dead-living donations predominate, the other type tends to pale in comparison. But this isn’t the case in the US. Like in Spain, the rate of living-living donors is put at 25 against every one million, commented Pruvo.
“But because the American population is much bigger, it follows that the number of patients on waiting lists is higher, which calls for the necessity of securing both types of donations, he said.
When persuasion is used to boost efforts in the direction of dead-living donations, the living-living type is undertaken amidst caution and rules.
“We have to understand that the entire issue of organ transplant depends on teamwork rather than individual effort, a fact that should trigger discussion on the required ethics, he noted.
Pruvot explained: “This is why in France it’s a matter which remains bound by the public health authorities’ control. And to enforce this, a number of restrictions had to be rigidly imposed.
Pruvot elaborated that in France, the use of imported organs is banned entirely. “Body parts should originated from local donors and operations must take place exclusively in public hospitals.
The second regulation is that anyone found to have undergone the procedure abroad will be denied his medical insurance and the right to the after-transplant follow-up.
A legal penalty that can even reach a prison sentence, will be the fate of any doctor who is caught clandestinely undertaking such operations, he added.
“The issue comes under the supervision of a national organization that compiles a database. Also scores of related centers across the country employ more than 3,000 specialists who are assigned following cases, deaths, priorities.etc.
Pruvot said: “In the case of living-living donations, we have to make sure that the donor has not been put under any psychological or financial pressure.
“In France the case is referred to court which has to verify reports relating to both the patient’s and the donor’s conditions, the degree of relation and the donor’s second thoughts.
He stressed: “But this type of transplant has to be practiced with the utmost caution. Mostly the donors are healthy and if anything goes wrong, their health will be endangered for life. Some 12 cases recorded worldwide in which donors died while giving their livers is really regrettable and shouldn’t have happened. Another issue is the quality of the organ. Is it in perfect, mild, or in bad shape?
But since living-living transplants can’t provide the required number of organs, it’s inevitable that specialists will encourage the second type.
About 40 years ago when the first successful heart transplant was undertaken and special medication was used to stabilize the planted organs, religious figures began to question whether the new technology would tarnish the sanctity of the dead.
“When both the medical necessity and the spiritual value were placed on the scales, the happy medium was to pay due respect to the dead body by restoring every distortion caused by surgery aimed at extracting organs, he stated.
“The law in France penalizes a surgeon who leaves the dead body in a destitute shape following the operation. A case in point is that of a French woman, who had bequeathed her face parts to a woman whose face had been irrecoverably distorted by her dog.
“Footage shown on how the dead body’s face was re-shape following plastic surgery was the talk of all specialists. We couldn’t believe this was a new artificial face.
Organ transplant is an issue that will remain subject to controversy, legislation and experimentation. And the future is replete with new frontiers: cloned organs, artificial organs and even animals-human transplants.
