Doctor speaks on organ donation challenges in Kuwait
By Ghadeer Ghloum
KUWAIT: After a patient reaches final stages of organ failure that may lead to severe illness and death, doctors recommend an organ transplant, which can save lives. However, the actual challenge lies not in the failure of organs or success of the operation, but in securing donated human organs, since finding donors remains a global issue for doctors who are trying to save their patients’ lives. Kuwait is first among Arab countries and second in the Middle East in organ donations after death, but the challenges doctors are facing still necessitate more donations.
Difficulties facing doctors
About the difficulties that doctors face over organ transplantation, President of Kuwait Transplant Society and head of organ procurement Dr Mustafa Al-Mousawi, who is a Fellow of the Royal College of Surgeons, told Kuwait Times: “The most difficult thing facing us as specialists in organ transplantation is to get enough donors. There’s an organ shortage all over the world, and not only in Kuwait or the Middle East. The number of patients that require organs is always greater than the number of donors available,” he said.
According to Dr Mousawi, the shortage of donated organs forms a global crisis, as the list of waiting patients is growing, whereas the number of available organs remains small. To support his claim, Dr Mousawi mentioned a credible website that provides daily updates on the number of patients who need an organ transplant. “In the United States, United Network for Organ Sharing (UNOS) shows hundreds and thousands of patients who are waiting for different types of organs, and some of them die while waiting.” Despite rapid medical development that gives hope for many victims of organ failure, the lack of donated organs keeps the risk of death present. Dr Mousawi said in Kuwait, there are around 600 patients on the waiting list, with the majority waiting for kidneys, pancreas and livers.
The categories of donors
Both living and deceased donors occupy an essential part in organ transplants. According to Mousawi, living donors can be split into two categories: Relatives and nonrelatives. In case the donor is a nonrelative, they have to be approved by the ethics committee. “Unrelated donors have to be interviewed by the ethics committee, which is based in Jahra Hospital and not at the transplant center. The ethics committee decides if the donor can donate or not because they need to make sure the donor is not paid for donation. Once the donors are approved by the ethical committee, then doctors can conduct an organ transplant surgery,” he said.
Compared to deceased donors, the number of living donors is fewer and limited to certain types of organs. Thus, organ donations mainly depend on people who die or who are brain dead. “With brain death, the heart still beats, which keeps the organs living even when the person is dead neurologically,” explained Dr Mousawi. He said donors are both Kuwaiti and non-Kuwaiti, but the majority are non-Kuwaiti due to various reasons including the fact that the number of expats in Kuwait are larger than the number of Kuwaitis, in addition to the incentives that the ministry or the Cabinet gives to non-Kuwaiti donors’ families.
“For example, if the deceased is from a certain country, the body is repatriated to that country at the expense of the ministry of health in Kuwait. Also, the ministry supports the deceased donor’s family if they are poor and in need of help” Dr Mousawi. Supporting non-Kuwaiti donors’ families has dual advantages, since it encourages a lot of people from the expat community to donate and help the patients on the waiting list survive, and it benefits the donors’ families by providing different kinds of support in return.
“Many of the deceased are poor workers with very low salary; therefore, they find the ministry’s support very beneficial. In other cases, the patients who receive donated organs promise to help the donor’s family. Hence, we connect both parties and they can help the donors’ relatives whenever they wish and some provide help on more than one occasion,” Dr Mousawi said.
Another encouraging benefit that Kuwait gives to non-Kuwaitis, because they form the majority of donors, is that the ministry of health and the transplant center give them organs from deceased donors for free. “Expats who are on the waiting list receive the organ for free and the transplant operation in Kuwait is free for expats,” said Mousawi.
Most demanded organs
Dr Mousawi emphasized on the significant demand for kidneys compared to other organs, despite the urgent need for all types of organs. “Kidney failure is the commonest type of organ failure, not only in Kuwait but all around the world, followed by the need for livers,” he said. According to Dr Mousawi, kidney donations and transplants constitute the largest number of transplants annually in Kuwait and globally. He also said that the majority of living donors choose to donate kidneys. Some people also choose to donate a part of their liver, since it is possible to donate half of the liver during one’s lifetime, and sometimes people donate a lobe of the lung to somebody who requires a lung.
Focusing on Kuwait’s annual organ transplants, Dr Mousawi said: “In Kuwait we do about 100 kidney transplants every year. Last year we did 50 kidney transplants from deceased donors and 49 from living donors.” He said the transplant center had a program for liver transplants in Kuwait, which stopped during the pandemic and has not resumed. Most patients still go to neighboring countries such as Saudi Arabia and the United Arab Emirates for liver transplants.
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