Triple swap transplant possible in TT...but is it legal?

Triple swap kidney transplants is medically possible in TT, but if it is legal to do so is a question yet to be answered. Transplant surgery has never been done involving people who are not related.

Professor Vijay Naraynsingh, vascular surgeon, described the transplant surgery involving three donors and recipients as historic.  He said the question is whether it can be done legally in TT. Professor Naraynsingh said only “live-related” (including people related by marriage) transplants are done in this country. The swap, which was done last Saturday in the US at John Hopkins Comprehensive Transplant Centre, Baltimore, is regarded as historic because none of the donors were related to recipients. Among the donors was Trinidadian Paul Boissiere, who donated a kidney to Jeremy Weiser-Warschoff. Boissiere’s fianc? Germaine Allum received a kidney from Connie Dick, whose sister Tracy Stahl got a kidney from Julia Tower, a friend of Weiser-Warschoff. Johns Hopkins Centre has a co-ordinating department which deals exclusively with matching donors to recipients. Boissiere has called for passage of legislation in TT to permit organ transplant by persons not related to each other.

Professor Naraynsingh said there is no law prohibiting or permitting non-related transplant surgery. Asked why it has not been done if there are no laws making the surgery illegal, he said the surgeon can be held liable if anything goes wrong. Other legal/ethical issues arise should the surgery be done in the absence of laws dealing with issues such as the sale of organs. Professor Naraynsingh said laws are needed which clearly define what is and is not permissible “or else the person doing it will have no defence.” Urologist Dr Fuad Khan said “with correct, staff, theatres, equipment, it can be done locally.” While there is less chance of rejection and better “immunological match” from a relative, all recipients receive immuno-suppressive drugs to prevent their white blood cells from attacking the organ. Kidney transplant costs approximately TT$75,000. The cost can go up to $100,000 should complications occur. For three transplants to be done, the cost triples because three sets of nurses, theatres, etc are required. Khan said if two theatres are used, the cost can be reduced. Live kidney transplants are nothing new in TT. They have been done at the Eric Williams Medical Sciences Complex. Dr Khan recalled four were done over a period of days.