The gift of life: Organ donation after death; a law yet to be implemented

Salonaz Sami, Thursday 14 Jul 2022

Ahramonline delves into the multi-faceted topic of organ donation in Egypt.


Organ transplantation has enabled many patients with terminal organ failure to have a longer and better life. But live organ donation offers a relatively limited number of organs due to the large gap between the number of donors and awaiting recipients.

The second source of organ donation is post-mortem. Understandably, the public acceptance of this type of donation is often a matter of controversy due to the moral and legal aspects of its regulation and implementation.

Article 8 of Egypt's organ transplant law allows the transplantation of an organ from the body of a deceased person to a living person if the deceased consented in a documented will. Article 10 calls for a registry to be created for patients in need of transplantation, which will be organised by need.

"Deciding to donate your organs is an enormous gift. You could help save up to eight to 10 lives by donating multiple organs and save up to 50 people with tissue, eye and even bone donations," explained Youssief Rady, the first Egyptian to officially register his will to donate his organs after death. There is no age limit; anyone can register to become an organ donor after death. However, to be able to do so, a person needs to die in hospital under specific circumstances.

"Medical specialists decide in each individual case whether a person's organs and tissues are suitable for donation," Rady added.

Last year, writer Khaled Montaser used his book signing event to call on intellectuals, artists, and influential figures to help raise awareness about organ donation.

Montaser urged them to register as organ donors to encourage the public and called for adding the donor status to driver's licenses.

"Blood and tissue types need to match for a transplant to be successful," Neurologist Mariem Raaouf explained. "Place of death also plays a factor in organ donation, since organs can only be donated within 48 hours of death, after which they need to be maintained in special facilities until ready for a transplant," she added.

Moreover, a person cannot become an organ donor if they have or are suspected of having certain conditions like HIV, cancer and Ebola.

However, "the real problem in Egypt is that the medical community cannot agree on a definition of death and is split between those who define death as death of the brain, and those who define it as death of the heart," Raaouf further explained.

"And without a clear, agreed upon definition of death, who will be able to decide a person is now dead and therefore their organs can be donated?" she wondered.

"What happens when we die? There are many answers, speculations and stories; however, there is only one answer that everyone agrees on and knows for a fact will happen, our bodies will rot," explained Doaa Hisham, a young branch manager.

"A lot of people go out of their ways to keep their names alive even after they die, and I think organ donation after death is the best way to do so," she added.

Religion also always comes up as an obstacle, as some religious edicts prohibit organ transplantation on the ground that Islam does not allow Muslims to give up their organs by selling or donating, whether during life or after death.

However, most Muslim scholars have given permission for organ and tissue transplantation to save human lives.

Moreover, Dar Al-Iftaa allowed organ transplants from living or dead donors in cases where they are meant to save the life of a patient at a chronic state and on the condition that such transplants are legal, and should not include any financial benefits for the donor, his family or his heir in case the donor is deceased.

"The Quran states that whoever saves the life of a human being, it is as if he has saved the life of all mankind," Hisham said.

In 2018, Sherif Al-Gazar, a young Egyptian-Greek, made it to the news when he donated his heart, liver and kidneys to save the life of four Chinese patients after he slipped in the bathtub and suffered from brain herniation, sight loss and respiratory system failure, while on a business trip in China. His sister signed the authorisation papers on air with her mother on the speaker phone.

However, "this is all impossible without implementing a solid system that is corruption-proof and takes into consideration everything from safe and sound transplants, to a fair waiting list with priorities always given to those in more critical conditions and not those with money," said Rady. 

The head of the Egyptian parliament's health affairs committee, Ashraf Hatem, said in a telephone interview on the Sada Al-Balad channel that the law regulating organ donations will soon be implemented.

"Work will be done with the government to introduce any needed amendments," he said.

"A few articles in the law need to be clarified before parliament so as not to cause confusion during implementation, including articles concerning the transfer of organs from a deceased person."

A cross sectional study was conducted over a period of two years among 2,743 adult participants, chosen from two healthcare facilities in Egypt: the Egyptian Liver Hospital and the National Research Centre.

Participants were both males and females between the age of 18 and 65.

According to the study, conducted by the National Research Centre and published in biomedcenteral, only half of the participants agreed to post-mortem organ donation (47 percent).

However, after explaining the process of donation, its regulation and consenting form to them, this percentage increased significantly to 78 percent.

"Our results suggest that increasing awareness about the subject could in turn increase its acceptance among the public. Efforts to improve educational programs and informational campaigns on the social and health benefits of organ donation could contribute to increasing the number of donations," the study stated.

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