Although the first kidney transplant that has been performed in Syria was back in 1978, but the kidney transplant program which was exclusively relied on blood related donors remained inactive, very irregular, and disorganized till only few years ago where the problem of organ shortage has inexorably grown up especially in a country like Syria where yet no deceased organ donation program is available, this made the situation more difficult and urged the health authorities in the year 2003 to provide an alternative and affordable source of organs that is from volunteer strangers or the so called Altruistic non-related living kidney donation program by enacting a new law that declared the act of kidney donation from living unrelated volunteers as generally acceptable providing the donation act to be free from coercion or any sort of money exchange between donors and recipients; And also, more importantly, this new law has recognized for the first time the concept of brain death and authorized the use of organs from deceased donors, therefore it constituted a landmark in the history of organ donation and transplantation in Syria. Since then, the practice of living unrelated kidney donation has particularly grown and flourished in some private kidney transplant centers; obviously, that was at the expense of decreasing living related kidney donation rate. Consequently, the kidney transplant rate has remarkably increased from 7 kidney transplants per million populations per year (pmp) in 2002 before the enactment of the new law to more than 17 kidney transplants pmp per year in 2007. Meanwhile, this tremendous growth of living unrelated kidney donation practice that has been mostly noticed and taken place in some private centers were unfortunately run by several "organ sale agents" involving different professionals including physicians, surgeons, nurses, brokers,etc. These illegal practices were of course targeting vulnerable individuals and inducing them to donate their kidneys. The involvement of unscrupulous agents in these transplant transactions has undoubtedly promoted organ commercialism rather than beneficent or altruistic aspects of organ donation. As underlined by the World Health Assembly resolution of 2004, there is need “to take measures to protect the poorest and vulnerable groups from transplant tourism and the sale of tissues and organs”. In consideration of the principles expressed in the above mentioned resolution and of the ethics of organ donation, and mindful of the possible consequences of the practices pertaining to organ trade and trafficking in our country, and following detailed discussion and exchange of thoughts and opinions, the government of Syria hereby released a pronouncement prohibiting all private centers in Syria to perform kidney transplantation and therefore, onward only the public hospitals will be authorized to perform kidney transplantation. In conclusion, live organ donation programs should not be developed in isolation without efforts to initiate deceased donor transplantation in order to lessen the burden of living donors and to enable a national self-sufficiency not only in kidney transplantation but also in heart, liver, lung, pancreas, and intestine transplantation as appropriate for the need of Syria.
Volume : 6
Issue : 4
Pages : 17
Surgical Kidney Hospital, Ibn-Alnafis Medical Complex, Damascus, Syria