The Doha Donation Accord Aligned With the Declaration of Istanbul

Abstract

Qatar is a Gulf peninsula country of approximately 1.7 million people, with a multicultural society of more than 80% non-citizen residents, mostly expatriate workers of Middle Eastern and Asian origin. Qatar ranks highly on the Human Development Index, with the highest health index in the Arab world (1). The first kidney transplant in Qatar was performed in 1986. Since then, lack of donors in Qatar has compelled most patients with end-stage renal disease to seek commercial transplantation abroad, returning to Qatar with high postoperative complications (68%) and a high early postoperative mortality of 12% (2, 3). Hamad Medical Corporation (HMC) is the main tertiary healthcare facility in Qatar. Following the publication of the Declaration of Istanbul (DoI) in 2008 (4), HMC adopted the recommendations of the Declaration by launching the Doha Donation Accord (DDA) in 2010 (5). The DDA has been developed by HMC and the Qatari Supreme Council of Health, in consultation with the Declaration of Istanbul Custodian Group (DICG), so as to meet needs for transplantation locally, thereby discouraging Qatari patients from undergoing commercial transplantation abroad. The DDA is thus intended to develop deceased organ donation and live related kidney transplantation in Qatar, leading to the eventual achievement of national self-sufficiency. Principles Underpinning the DDA The primary objective of transplant policies and programs should be the promotion of health through provision of optimal care to both donors and recipients. Financial considerations or material gain of any party must not override consideration for the well-being of donors and recipients, nor influence the application of relevant organ allocation rules. Consistent with the Qatari Transplant law 21 of 1997 (6) and the World Health Organization Guiding Principles on Human Cell, Tissue and Organ transplantation (7), the DDA prohibits trade in human organs and financial rewards for organ donation. Qatar is notable for the fact that organs for transplantation are equitably allocated within Qatar to suitable Qataris and expatriate patients residing in Qatar alike, without regard to citizenship status. The acts of heroism by all donors whether living or deceased are acknowledged by a representative of the Qatari government, awarding a medal of honor to the live donor or the deceased donor family in recognition of their gift of life.