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The head of the national kidney transplant programme at Beaumont Hospital, Dublin, advised the HSE it was ready to “seriously commence” non-directed altruistic donation by early 2019. However, Consultant Transplant Surgeon Ms Dilly Little added that “on repeated discussions and repeated submissions to the Department of Health, my understanding is that they would prefer if we had a regulatory body” outside Beaumont Hospital.
In her letter last September to Prof Jim Egan, Director of HSE Organ Donation and Transplant Ireland (ODTI), Ms Little said in some centres in the UK, altruistic (non-directed) donors provided “a very valuable augmentation to the kidney transplant programme”.
She stated that the “exact constituency” of the regulatory panel proposed by the Department was “unclear to me and I would therefore welcome this matter to be discussed” at the National Organ Donation and Transplant Advisory Group, so that members from the Department “can direct me as to how I might progress this project further”.
In the interim, the hospital was completing its work on the consenting process for patients awaiting kidney transplant, “which will include the concept of altruistic donation and we have put in place all of the necessary protocols to complete a work-up, including interviews with members of the psychosocial team as well as medical and surgical teams here in Beaumont Hospital”.
The Department has previously informed the Medical Independent that non-directed altruistic kidney donation is “a complex area” requiring the “protection of a robust legislative framework”.
The General Scheme of a Human Tissue (Transplantation, Post-Mortem, Anatomical Examination, and Public Display) Bill, published in May, provides for non-directed altruistic donation.
Currently, Beaumont undertakes kidney transplants from altruistic donors who are relatives or close friends of the recipient. There were 40 such transplants in 2018, down from 51 in 2017. Some 429 patients were awaiting renal transplantation at the end of 2018.
A group overseeing governance of altruistic organ donation is being established by the ODTI to ensure “safe and ethical use of organs”.
According to draft terms of reference for the group, it will ensure the transplant centre has considered the welfare of the donor prior to the potential benefit to a recipient.