Kidney exchange amendment proposed for Hong Kong organ donation law

from Market Design at on April 29, 2018 at 01:18PM

A bill introduced in Hong Kong clarifies that kidney exchange doesn’t count as (forbidden) "inducement" to donate an organ under the law. (In this respect the bill seems to parallel the Norwood Act which amended the U.S. National Organ Transplant Act for the same reason.)  The bill excludes exchange of different organs (about which I recently blogged here.)

Human Organ Transplant (Amendment) Bill 2018 gazetted

"Hong Kong (HKSAR) –      The Government published in the Gazette today (April 27) the Human Organ Transplant (Amendment) Bill 2018, which seeks to allow for paired/pooled organ donation arrangements in Hong Kong.

     A spokesman for the Food and Health Bureau said, "Living donation offers an alternative for individuals awaiting transplantation from a deceased donor and increases the existing organ supply. There are however cases where the patient who needs an organ transplant has a living related donor who is willing but unable to donate because of an incompatible blood type or tissue type. One option would be paired donation."

     Under a paired donation arrangement, both medically approved incompatible donor-patient pairs donate organs to the other pair so that the patients in both pairs receive compatible organs.

Currently, as stipulated in section 5D(1)(c) of the Human Organ Transplant Ordinance (Cap 465) (HOTO), the donor has to give his consent to the proposed organ removal without coercion or the offer of inducement before any organ transplant between living persons can take place. Under a paired or pooled organ donation, a donor is willing to donate his/her organ to a stranger in exchange for another donor donating his/her organ to the first donor’s originally intended recipient. While the term "inducement" is not specifically defined, the Government intends to amend HOTO to clear any legal ambiguity as to whether a paired organ donation involves "inducement".

     "The Hospital Authority is proposing a pilot Paired Kidney Donation Programme, participation in which will be voluntary.

The donor from the first incompatible donor-recipient pair (‘dyad’ as defined under the Amendment Bill) would donate to the recipient of the second dyad, and the donor from the second dyad would donate to the recipient of the first dyad," the spokesman said.

     The Amendment Bill will be introduced into the Legislative Council for scrutiny on May 9."
Here’s the bill: Human Organ Transplant (Amendment) Ordinance 2018.
"A bill to Amend the Human Organ Transplant Ordinance to provide that a donor is not to be regarded as having given consent to a proposed organ removal with the offer of inducement only because the consent has been given in consideration of a proposed organ transplant into a person chosen by the donor under a donation arrangement."

And here’s the Legislative Council Brief.
Interestingly, it contains the following stipulation:
"6. In order to better describe the paired and pooled donation arrangements, we intend to introduce a new concept of a dyad, which is a group of two persons consisting of a donor and a beneficiary. The definitions for paired and pooled donation arrangements are also expressly set out. To avoid any impression or possibility that different types of organs could be exchanged under such
arrangements, organs to be removed and transplanted under the arrangements are restricted to be of the same kind and every removal and transplant is to be carried out by a registered medical practitioner in Hong Kong."