Govt to introduce kidney swapping. Will it bridge the country’s transplant gap?

Infographic: TBS

One of the reasons Bangladeshi patients seek treatment abroad is for organ transplants. The government has now initiated efforts to amend the Organ Transplant Act in order to increase the transplant rate within the country.

To boost transplants, opportunities for kidney swapping between patients' relatives will be introduced, along with efforts to increase cadaveric kidney transplants (from brain-dead patients).  

A "kidney swap" occurs when a living donor is incompatible with his or her recipient but matches another person on the wait list, resulting in two live donor transplants.  

In Bangladesh, 3.8 crore people are affected by kidney disease, with 30,000-40,000 suffering from permanent kidney failure each year. While the country needs 5,000 kidney transplants annually, only around 400 are performed, according to a recent study by the Kidney Awareness Monitoring and Prevention Society.  

Due to a shortage of donors, the number of kidney transplants in the country falls short of demand. The Human Organ Transplantation (Amendment) Act 2018 allows 22 types of relatives – such as parents, siblings, spouses and grandparents – to donate a kidney to save a patient's life.  

However, transplants are often not possible due to mismatches in tissue, blood group or other factors.  

Professor Dr Sayedur Rahman, special assistant to the chief adviser for the health and family welfare ministry, told The Business Standard, "We are amending the Organ Transplantation Act to allow organ swapping, enabling exchanges between relatives."  

While kidney donation must come from a close relative, donor swapping is possible, he said, adding that if a close relative's kidney doesn't match the patient, he or she will be placed in a donor pool.  

"If they match another patient's relative, they can donate the kidney. Both surgeries will be performed simultaneously, and a national donor pool will be created," he added.  

Professor Rahman said a draft of the organ transplant law has been prepared based on expert opinions, with only some technical work remaining. "The health ministry will finalise the draft and send it to the law ministry within a month," he added.  

Speaking to TBS, Professor Dr MA Samad, founder and president of the Kidney Awareness Monitoring and Prevention Society, said a kidney transplant is the best option for kidney failure, allowing patients to lead almost normal lives.  

He said dialysis, on the other hand, disrupts normal life, requires machine dependence, and is costly and painful.  

"Due to the donor crisis, kidney transplants are limited in our country," he said. "If the law is amended to expand the donor pool and people are educated and motivated about cadaveric transplants, kidney transplants will increase."  

So far, two cadaveric kidney transplants have been performed in the country. The first was carried out in January 2023 at Bangabandhu Sheikh Mujib Medical University (BSMMU).  

Brain death occurs when the brain stem stops functioning due to a stroke, brain injury, surgery or other causes. After brain death is certified, written consent must be obtained from the deceased person's next of kin (such as spouse, parents, siblings, or adult children) before organs can be harvested.

In 2024, two brain-dead patients' kidneys were transplanted at the state-owned health facility.  

Professor Sayedur Rahman said, "We plan to honour cadaveric donors. Those who donate organs will be recognised socially and nationally while they are alive."  

Thursday is World Kidney Day. The theme for this year is "Are Your Kidneys OK? Detect early, protect kidney health."  

Dr Shekh Moinul Khokon, founder and president of Human Aid Bangladesh Foundation, told TBS, "The number of kidney patients is rising. Emphasis should be placed on prevention, as 70% of kidney diseases can be avoided. High blood pressure and diabetes must be controlled."