CHRONIC kidney disease (CKD) has become a global public heath concern with over 2 million people currently requiring renal replacement worldwide. Kidney failure, or end-stage renal disease (ESRD), which is the possible outcome of CKD, requires costly renal replacement therapy in the form of dialysis or transplantation to sustain life. With the unprecedented rise in demand for kidneys and other human organs for transplantation, either due to the increased awareness among patients or the widespread availability of advanced treatment facilities, and with wealthy patients willing to spend a fortune on illicit transplants, a $1.5 billion black market for donors has thrived alongside. The World Health Organization has estimated that around 10,000 illegal transplants take place every year, with patients paying up to $200,000 for the operation. In the past five years, Saudi Arabia has prevented at least 27 people from donating organs as commercial motives were suspected. In a wide-ranging interview with Okaz/Saudi Gazette, Dr. Faisal Bin Abdul Rahim Shaheen, director general of the Saudi Center for Organ Transplantation (SCOT), cited the growing need for more organ donors in the Kingdom, but he reiterated Saudi Arabia's determination to fight all forms of organ trade. Shaheen downplayed the growing number of renal failure cases in the Kingdom, saying it was a universal phenomenon and not caused by any system error. "This is a problem facing all countries of the world," he added. There are at least five main reasons for the increase in renal failure cases: Population growth; early detection of the disease; increased life expectancy; improvement in services provided by dialysis centers; and availability of effective medicines, he said, adding: "All these factors will increase the number of patients looking for organ donors." The SCOT chief said his organization was pressing for the inclusion of the "organ donor" title in driving licenses of people who intend to donate organs. "The Shoura Council has already discussed the matter as part of revising the traffic law. This system is being implemented in advanced countries, especially due to the increasing number of deaths due to road accidents. We hope the authorities would soon implement the system in the Kingdom," he said. Shaheen said his organization has intensified its campaign to encourage more people to donate organs before or after death to save the lives of patients through awareness programs and seminars and conducting field visits to hospitals and relevant organizations. "Saudi Arabia holds 4th position in the world in kidney and liver transplant operations with organs harvested from living donors and 44th position in operations with organs from brain-dead patients," he pointed out. Asked about the center's efforts to prevent organ trade, Shaheen said: "We have prevented 27 people during the past five years from donating organs after suspicions that they had commercial motives." He said no fraudulent cases have been found among brain-dead donors as the reward for such donations goes to the heirs of the dead and is given in the form of checks issued by Saudi Arabian Monetary Agency. The money goes straight to the actual heirs of the donor. "With regard to living donors, the reward will be given only after checking their medical records. They should also produce necessary documents provided by the hospital that conducts the transplant operation," he explained. Shaheen highlighted the remarkable progress achieved by the Kingdom in organ transplant operations and health services with the support of advanced infrastructure facilities. "The government has set up specialized hospitals and clinics all over the country with advanced medical equipment and facilities. This has helped early detection of diseases and ensured advanced treatment to patients," he pointed out. Shaheen said early detection of kidney diseases would help prevent renal failure. "We have noticed tremendous improvement in preventing cardiac diseases and other chronic ailments as a result of advancement in healthcare in the Kingdom." Answering another question, Shaheen said there are 13 kidney treatment centers across the Kingdom serving 18,000 renal failure patients. "These patients are given dialysis services while 6,000 of them have been enrolled on the waiting list for transplant operations." Transplant operations are performed on the basis of an approved list. However, Shaheen said some patients are given priority, considering the critical nature of their condition. "We perform transplant operations for such patients as soon as a donor is available," he said. A website has been created to register potential organ donors. "About 3 million donors have signed the donor cards either by visiting the center or hospitals or while attending events. Our objective is to register 10 percent of the population as organ donors within the next six months." Shaheen said the donation of one of the two kidneys and part of liver accounts for 10 percent of total organ donations in the Kingdom. "We follow strict regulations in organ donation to drive away illicit donors. This move has been welcomed by public and private agencies including Prince Fahd Bin Salman Charitable Society for the Care of Renal Failure Patients," he added. Shaheen warned renal failure patients against herbal cures, saying any unproved treatment could endanger their lives. "I have personally received some patients whose condition deteriorated after taking herbal medicines," he said, while urging the public media not to promote such medicines. He said SCOT would continue to combat organ trade by some agents. "Saudi Arabia is one of the countries that have endorsed the Istanbul Agreement that prevents illegal organ trade. We have also advised patients not to heed calls by suspicious agencies that arrange kidney transplant operations outside the Kingdom taking huge amounts of money." Shaheen added: "I personally know some Saudi renal failure patients who have been cheated by kidney brokers in Asian countries. People have to approach authorized healthcare providers for treatment without involving agents who exploit the situation of patients to make money." He emphasized the need to take legal action against such illegal brokers who endanger people's lives and cause them financial losses. The GCC committee for organ transplant held a meeting in the UAE recently and adopted a number of resolutions. It reiterated its support for Istanbul Agreement that bans organ trade and stressed the need to follow the decisions of World Health Organization. The meeting also decided to establish a higher consultative commission for organ transplantation in the GCC with headquarters in Riyadh. It will have one or two representatives from each GCC country. The meeting urged Bahrain, Oman and the UAE, which do not have organ transplant centers, to set up such centers as quickly as possible. It stressed the need to focus on intensive care units and exchange information about brain-dead patients in each member country to make use of their organs to save lives.
