BY: Salma Khalik, Health Correspondent

THE head of a government committee on health issues has suggested that the decision-making on organ donation be taken out of the hands of hospitals carrying out transplant operations.

Perhaps the job should fall on an independent committee appointed by the Ministry of Health (MOH), said Madam Halimah Yacob.

Commenting on the recent convictions of two Indonesian men on organ-trading offences, the head of the Government Parliamentary Committee for Health called for a review of the existing system which approved the two transplant operations when 'alarm bells should have gone off'.

'To me, it is quite surprising that in one case, as many as seven samples were submitted,' she said, referring to the blood samples from seven people which were sent here for compatibility tests against that of one potential recipient.

Madam Halimah added that the fact that the middleman in the two recent cases was known to the hospital should also have prompted a closer look at the cases. She also questioned the ability of a hospital's ethics committee 'to sieve and detect genuine relationships from phoney ones'.

Here, she was referring to the job of these committees to examine the strength of the ties between donor and recipient, to rule out the possibility that the donation is a commercial transaction.

Since changes to the Human Organ Transplant Act in 2004, hospitals have not needed to get MOH approval when organs are donated by non-relatives. This was the case with Sulaiman Damanik, who was convicted last week of agreeing to sell one of his kidneys to retail magnate Tang Wee Sung.

Transplants are allowed so long as the hospital's ethics panel okays them; hospitals only have to keep MOH informed. The panel has to ensure, among other things, that the donor knows full well what is involved, and was neither coerced into parting with his organ nor paid for it.

Mount Elizabeth Hospital handled 171 of the 300 kidney transplants from living donors done since 2004; Gleneagles has a near-monopoly on live-donor liver transplants, having carried out 94 of the 109 live-donor liver transplants in that period. The overwhelming majority were transplants in which both donor and recipient were foreigners.

The two Indonesians convicted last Thursday of selling their kidneys are likely to be the first among several people to be taken to task for running afoul of the law. More charges are expected to be filed, perhaps in the next few days, The Straits Times understands.

It is a crime to trade in organs here, and both buyers and sellers are liable, as are the middlemen who gain financially from it. MOH told The Straits Times that it is investigating 'a possible organ trading syndicate' but is 'not targeting any hospital in particular'.

Police and MOH officials have seized all records for live-donor transplants done at Mt Elizabeth and its sister hospital Gleneagles going back to 2002. Both are part of the ParkwayHealth Group and share a transplant office at Gleneagles.

Aside from notes on decisions by the hospitals' ethics committees, in-patient medical files were also seized.

This article was first published in The Straits Times on July 7, 2008.