Consequent to 18thConstitutional Amendment, the Transplantation of Human Organs and Tissues Act, 2010 [1]was one of the laws which the Provinces had to review/revise or adopt as it was. In Khyber Pakhtunkhwa, a newlaw called the Khyber Pakhtunkhwa Medical Transplantation Regulatory Authority Act, 2014 [2] was enacted through the Provincial Assembly on 02.04.2014. Its preamble states itspurpose as “to provide for regulation, removal, storage and transplantation of human organs, tissues and cells for therapeutic purposes in the Province of the Khyber Pakhtunkhwa and to establish the Khyber Pakhtunkhwa Medical Transplantation Regulatory Authority”
Essentials of the Act
Section 5(4) – there shall be Medical Transplantation Regulatory Authority. The Regulatory Authority shall regulate, monitor and control all the transplantation of human organs and various committees constituted under the Act. The Regulatory Authority shall cause to establish a Provincial Registry and Provincial and regional networks for evaluating quality and outcome of transplant centres and cause enhancement and promotion of transplantation. It shall establish pool of voluntary donors and registry of potential recipients and regulate it in a manner as prescribed.
The Regulatory Authority will by notification in the official gazette recognize Medical Institutions and hospitals for practice of operative surgery and transplantation of human organs. No hospital or medical institutions shall carry out transplantation of human organs unless it is recognized by the Authority.
Section 13 – the Regulatory Authority may by, notification in the official gazette constitute, Transplant Evaluation Committees for recognized institutions. Each Transplant Evaluation Committee shall consist of a recognized surgical specialist, a recognized medical specialist, a recognized Transplant Specialist, a recognized Nephrologist, a recognized neuro-physician and a recognized intensivist where available and two local notables having a good record of social service. The Transplant Evaluation Committee shall be chaired by the Head of recognized Medical Institution.
The Transplant Evaluation Committee shall:-
- Ensure that no organ or tissue is retrieved from non-related living donors without the prior approval of Evaluation Committee.
- Determine brain death of a person.
- Determine propriety of removal of a human organ from any living person after formal informed consent, in cases of partial donation of an organ or donation of one paired organs.
- Determine propriety of removal of a human organ from any living person using brain death protocol to be formulated.
- Determine fitness or otherwise for transplantation of a human organ into any other body and determine the fitness of the recipient.
- Determine the fitness of recipient.
Section 14 – the Regulatory Authority shall, by notification in the official gazette constitute a Transplant Monitoring Committee. The Transplant Monitoring Committee shall consist of a Chairman and six members.
Section 15 – the Regulatory Authority shall, by notification in the official gazette constitute a Transplant Inquiry Committee. The Transplant Inquiry Committee shall investigate and hold enquiry into the allegations of breach of any provision of Khyber Pakhtunkhwa Medical Transplantation Regulatory Authority Act, 2014. The Transplant Inquiry Committee has three members whose Chairman is the Director General Health Services, Khyber Pakhtunkhwa.
Donation of organ or tissue by living person. In terms of Section 3 of the Act living donor who is not less than eighteen years of age, may during his life-time voluntarily donate any organs of his body, or tissue or cell to any other living person genetically related, who is a close blood relative (i.e parent, son, daughter, sister, brother and spouse) for therapeutic purpose. The Transplantation shall be voluntary, genuinely motivated and without any duress or coercion. In case of non-availability of a donor, the Transplant Evaluation Committee, may allow donation by a non “close blood relative” satisfying itself that such donation is voluntary.
Donation of human organs after death. In terms of Section-4 of the Act, any person who is not less than eighteen years of age, may before his death, in writing duly singed and verified by respective Transplant Evaluation Committee, donate any of his organ or tissue for transplantation and for this purpose, may authorize any medical institution or hospital duly recognized by the Regulatory Authority. On the death of a donor any close relative of the deceased shall inform the Transplant Evaluation Committee about the deceased and cause of the removal of the human organ or tissue in accordance with the authorization. The cases of unclaimed brain dead hospitalized patients shall be presented to the Transplant Evaluation Committee for transplantation, after an intense search for their relatives within a reasonable time.
Effect to the donor and recipient. In terms of Section 18 of the Act, no transplantation of human organ from a donor other than for therapeutic purpose, shall be carried out without prior permission of the appropriate Transplant Evaluation Committee and only at such medical institution and hospital which have been recognized medical institution shall undertake the removal or transplantation of any human organ from a living donor unless they have explain the effect, complications and hazards connected with the removal of organ or tissue or cell for transplantation to the donor and its outcome in the recipient respectively.
Punishment for removal of human organ without authority. In terms of Section 20 whoever renders his service to or at any medical institution or hospital and who for the purpose of transplantation, conducts, associates with or helps in any manner in the removal of any human organ without authority, shall be punished with imprisonment for a term which extended to ten years and with fine which may extend to one million rupees.
Punishment for commercial dealing in human organs. In terms of Section 21 of the Act, those who are involved in commercial dealing in human organs shall be punished with imprisonment for a term which may extended to ten years and with fine which may extend to one million rupees. The commercial dealing has been defined in the following manner:-
Whoever:-
- Makes or receive any payment for the supply of, or for any offer to supply any human organ.
- Seeks to find a person willing to supply for payment of any human organ.
- Offer to supply any human organ for payment.
- Initiate or negotiates any arrangement involving the making of any payment for the supply of, or for any offer to supply any human organ.
- Takes part in the management or control of a body of a person, whether a society, firm or company, whose activities consist of or include the initiation or negotiation of any arrangement involving the making of any payment for the supply of, or for an offer to supply any human organ.
- Publishes or distributes or causes to be published or distributed any advertisement, inviting persons to supply for payment of any human organ or offering to supply any human organ for payment or indicating that the advertiser is willing to initiate or negotiate any arrangement involving the making of any payment for the supply of, or for any offer to supply any human organ.
In pursuance of the aforementioned Act, the Khyber Pakhtunkhwa Medical Transplantation Regulatory Authority has been established vide Notification dated 02.11.2016. Further, Transplant Monitoring Committee has also been constituted vide Notification dated 29.09.2016.
On 11.10.2017, the
Government of Khyber Pakhtunkhwa, by notification in the official Gazette, has
made rules for carrying out the purpose of the aforementioned Act called the Khyber
Pakhtunkhwa Medical Transplantation Regulatory Authority Rules, 2017. [3]
Hospitals granted licenses till September 2018
Renal Transplant Centres registered with MTRA
1. Institute of Kidney Diseases Peshawar 2. Rehman Medical Institute Peshawar 3. North West General Hospital Peshawar
Corneal Transplant Centres registered with MTRA
1. Khyber Teaching Hospital Peshawar 2. Lady Reading Hospital Peshawar 3. Hayatabad Medical Complex Peshawar 4. Rehman Medical Institute Peshawar
[1] http://www.punjablaws.gov.pk/laws/2428a.html
[2] http://kpcode.kp.gov.pk/uploads/2014_11_THE_KHYBER_PAKHTUNKHWA_MEDICAL_TRANSPLANTATION_REGULATORY_AUTHORITY_ACT_2014.pdf
[3] http://www.healthkp.gov.pk/wp-content/uploads/2017/10/Medical-Transplantation-Regulatory-Authority-Rules-2017.pdf
