Lebanese health professionals announced a series of recommendations for medical transplants Tuesday to begin fixing the country’s organ and tissue donation procedures, starting with cornea operations.
The recommendations include centralizing the country’s organ and tissue donations under the National Organization for Organ and Tissue Donation and Transplantation, an organization that works with the French organ donation program to change donation practices in Lebanon.
The recommendations, endorsed by the Health Ministry, Order of Physicians and hospital leaders, suggest beginning the reform process by improving local cornea donation.
“I think the first thing is to increase the [local] procurement of corneas,” said Beatrice Senemaud from Agence de la Biomedecine, who is visiting Lebanon to help change its organ donation practices. “Now it [local donation] doesn’t meet the needs at all.”
Transplanting the outer layer of the eye can restore sight to people with damaged or diseased eyes and the operation is one of the least invasive donation procedures. Because of their small size, corneas are thought to be a good starting point for increasing transplants in countries like Lebanon where families resist having their loved one’s organs and tissues removed.
The national eye bank at a hospital in Karantina has made vast progress in regulating local cornea donations that used to have a waiting time of several years and almost no oversight before 2000, said Elias Warrak from St George University Hospital. The eye bank organized around 70 donations last year and offered corneas for around $200 in contrast to the international cost that can run up to $2,000.
But hundreds of the procedures are happening across the country every year and most operations are done with corneas shipped in from abroad.
Many hospitals have separate procedures for identifying donors and recipients, making wait times for corneas vary widely. Health officials want to centralize the process with the recipient list maintained by the national organ organization.
They also want to source the majority of corneas from inside Lebanon. But to do that, health officials will have to confront a strong cultural stigma against donating organs.
“Unfortunately I think the experience with local donation is not as successful as international,” said Randa Haddad, a director at the The American University of Beirut hospital.
“People don’t accept the discussion of organ donation at the time of death, it’s difficult to break through,” she said.
One of the main problems is cultural resistance from people who say harvesting organs violates the sanctity of the body. Relatively few people consent to organ donations every year.
Organ donations are largely unregulated in Lebanon and current laws are vague. Donations not from relatives are supposed to be approved by the National Organization for Organ and Tissue Donation and Transplantation. But the reach of the organization remains limited. And more oversight is needed.
“As you can clearly notice the situation has been changing,” said Walid Ammar from the Health Ministry.
“I think it’s time to have regulation, strict regulation.”
