Deceased Donor ProgramHuman Organ and Transplantation Law

History of Transplant Law

• 1979
  Renal transplantation started in Pakistan in public sector hospitals using exclusively living related family donors.
• 1990s
  Renal transplant activity increase to more than 500/year
• 1990s
  The transplant bill was introduced in the Senate. The bill was based on the Charter of United Nations, Human Rights and Laws formulated on the guidelines of WHO and The International Transplantation Society (TTS). Pakistan like any other respectable country became signatory to uphold the rights of the donors and human rights.
• 1990s
  Renal transplantation exceeded over 1000/year, however there was a paradigm shift from using living related family donors to unrelated paid commercial donors who constituted more than 80% of all transplants.
• 2000s
  All attempts to promulgate the law were stopped and blocked by the powerful commercial lobby who had turned Pakistan into the cheapest organ bazaar of the world where more than 1500 transplants per year were performed for foreigners at $20,000 to $30,000.
• 2007
  The plight of the donors who were mostly poor and impoverished of our society in bonded labour was highlighted by the local and foreign press. Pressures from WHO, TTS and International Forum for the care of the live donor lead to judicial activation. The Supreme Court issued suo-moto notice to the government to promulgate the transplant law.
• 2007
  The Transplant Ordinance 2007 was promulgated in September 2007. It prohibited the sale of organs, transplant of foreigners and allowed deceased donor transplantation.
• 2008
  The commercial lobby tried to bring changed in the law to allow sale of organs and transplantation of foreigners by introducing an amended bill in the National Assembly. A Select Standing Committee of Health rejected the proposed amendments and fully endorsed the law.
• 2008
  Commercial transplant centers then filed a case in the Federal Shariat Court of Pakistan challenging the law that it was against the laws of Islam and requested that sale of organs and transplant of foreigners be allowed in view of Islamic brotherhood. The Shariat Court rejected this petition and declared that sale of organs in un Islamic.
• 2009
  Supreme Court issued Suo-moto notice to private centers doing paid donor transplant of foreigners. And the relevant centers appeared before the court and gave assurances that they would discontinue unethical transplantation.
• 2010
  The bill for organ transplantation made history as it was passed unanimously by the two houses of legislature, the National Assembly and the Senate. In March the president of Pakistan signed the bill and it became part of the constitution of the Country.
• 2011
  Overwhelming evidence that organ trafficking is on the rise.

Salient features of Transplantation of Human organs and Tissues Ordinance 2007

1. Donation of organ or tissues by a living person has been limited to only genetically related members and spouses. In case there is no family donor then a non blood relative can donate only if Evaluation Committee allows after satisfying that such a donation is voluntary and no compensation is involved for organ donation. This is a very important step to prevent organ sale and trade.
2. This legislation is the initiation of deceased (cadaver) donor programme in the country.
3. The Evaluation Committee has been made comprehensive to evaluate each transplant either living or deceased. For deceased donor a team constituting neurosurgeon, neurophysician and intensivist will certify the brain death and they will not have any relation to the transplant team to make sure that there is no conflict of interest. Moreover two notables from civil society and to be nominated which will ensure transparency and prevent exploitation of the poor.
4. The law specially states that foreigners cannot travel for the sole purpose of transplantation.
5. The law stipulated creation of a Government Fund with collaboration of NGOs and philanthropists which will help poor and indigent patients for the treatment after transplantation.
6. The law has created a Monitoring Authority, a federal body with very senior members from across the medical fraternity who will overseas the transplant activity across the country.
7. Each transaction done in the country is proposed to be entered into a database for scrutiny as regards the donor status as well as outcome of the transplant and its success.
8. In the legislation, the punishment for any contravention of the law has been enhanced so as to act as a deterrent. The maximum punishment of ten years imprisonment with a fine of Rs. 10 lacs has been included for major criminal activities in relation to the legislation.