Organ and Tissue Donation: An Evidence Base for Practice

By Magi Sque; Sheila Payne | Go to book overview

Appendix 1
Issues raised by the Human
Tissue Act with regard to living
donation

Patricia M. Franklin and Alison K. Crombie

Most European countries have laws permitting the use of living donor organs, and are therefore fundamentally supportive of the practice of live donation.

Legislation in the UK has until recently been perhaps the most prescriptive in Europe, partly because it was introduced to prohibit commercial dealings in human organs. As a direct consequence, living donor transplants in the UK are at present regulated by the Human Organ Transplants Act 1989. The Act goes considerably further than simply barring payment for organs for transplantation, it states that a person commits an offence if he or she removes an organ or transplants an organ from a living donor unless the recipient is genetically related to the donor. The Act defines very precisely what a genetically related donor means.

A person is genetically related to his or her natural parents and children; his or her brothers and sisters of the whole or half blood; the brothers and sisters of the whole or half blood of either of his or her natural parents; and the natural children of the brothers and sisters of the whole or half blood of either of his or her natural parents.

The Act does not, however, recognize grandparents or more distant relatives as genetically related. At the time of the Bill the Under Secretary announced that the Bill had been drafted to permit organ transplants between close relatives because there are clinical advantages, they are more likely to be compatible in a medical sense, and the motives of a donor, who is a relative, are more likely to be altruistic.

The Act also stated that before any related-donor transplant could take place, specified genetic testing of donor and recipient must prove the claimed genetic relationship. The Act did allow unrelated living donor transplants to be performed, but only after very considerable scrutiny. The Act established a Committee, the Unrelated Live Transplants Regulatory Authority (ULTRA), with power to authorize transplants between non-genetically related donors

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