National Organization for Organ and Tissue Donation and Transplantation
Mission of the NOOTDT
The NOOTDT is responsible for all the missions and tasks aimed at promoting and organizing the organ donation program in Lebanon in a comprehensive manner and it communicates with hospitals, media outlets and NGOs to serve this aim. In 2010, the cooperation agreement signed with the Spanish government included 15 Lebanese hospitals, a number which grew to 23 in 2011. A manual briefing on the requirements needed to make part of the organ procurement process is usually handed out to hospitals, and it’s up to them to join the cause or opt out. Spreading the concept and culture of organ and tissue donation and transplantation and staying informed of the medical progress and the latest advances in this field fall also within the work the organization. It is noteworthy that the NOOTDT has organized during the past three years awareness campaigns in more than 60 military centers, 65 public schools in addition to diverse private schools and NGOs, and has met deans from Lebanon’s universities to arrange the inclusion of an organ procurement course in all the faculties of medicine, pharmacy and nursing across Lebanon.
Donation mechanism
The Lebanese law recognizes two modes of death: the classic manner resulting from cardiac arrest and cessation of breathing and the scientific manner meaning brain death or actual death. At the moment, the NOOTDT is focused on providing the organs and tissues of brain dead patients. In scientific terms, a patient is diagnosed as brain dead, when there is a total loss of the entire activity of his central nervous system and all its vital functions. The model adopted entails the formation of hospital committees consisting of procurement coordinators, coroners and physicians trained to determine potential donors, inform the NOOTDT thereof, report their death immediately when it occurs, communicating with the parents of the deceased to gain their approval regarding the donation of their tissues or organs, and manage, distribute and use the organs, thus establishing the link between the organization and hospitals.
Brain death must be confirmed through bedside examinations administered by neurologists and anesthesiologist, together with an electro-encephalogram (EEG) aimed to assure that the death has occurred before proceeding with the donation mechanism. The NOOTDT has a waiting list including the names of the patients who need and are ready to undergo organ transplantation, along with the compatibility criteria between donors and recipients (blood type, age, immunity level…) and the contact details of the surgeons assigned to carry out the transplant surgeries. Those details steer the transplantation process at a faster pace and increase its success rate. Once removed from the donor’s body, the heart, for instance, can remain usable for 6 hours depending on preservation conditions. Therefore, it is preferable that the NOOTDT have all the details and updates regarding the condition of the waiting recipient at their disposal, to gain time and move to the surgery immediately after obtaining the organs or tissues.
The organs that are transplanted most often in Lebanon are kidneys. With the artificial kidney device now in the market, patients suffering from kidney failure can wait longer on the waiting list, contrary to those with heart or liver failure, to whom time can be a life-saving factor.
Currently, the NOOTDT is providing in addition to the corneas, a yearly average of 40 organs from 10 donors, a number, which pales in comparison to other countries. However, the transplant success rates are considerably high and survival increases to over 10 years if recipients are committed to taking their immune suppressing drugs for life, to rule out the possibility of their body rejecting the transplant, which naturally makes them susceptible to other infections and illnesses.
Dr. Antoine Stephan, Vice President of NOOTDT, assures that the stringency of laws in Lebanon curbs the spread of organ trafficking. He adds that should there be any illegal organ donation practices, they are limited to individuals, not clinics or hospitals.
Between law and religion
The Lebanese law 109/1983 and its amendment 1442/1984, legalize “donation of human tissues and organs for medical and scientific purposes”. The law also requires the consent of the family to the disposition of the organs of the brain dead patients, even if they had signed when alive a card giving their permission to donate their organs or tissues.
From religious and ethical perspectives, most religions have voiced their support of organ and tissue donation, provided that the process remains far from commercialism and respects the dignity of both the recipient and the donor, insisting on the importance of receiving the approval of the donors or their families.
It is our duty to support and promote a generous and noble cause such as an organ donation, as it brings hope of life and a better tomorrow and spreads sublime values among humans.
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