The Effect of Legal Initiatives on Deceased and Live-Donor Kidney Transplantation in Israel

Abstract

Istanbul Declaration has been adopted in many countries and professional societies around the world. However further efforts are needed in each jurisdiction and country to increase donation rate and number of transplants. We review the effect of recent legal initiative in Israel on the number of kidney transplantation. Methods: Two laws were passed by the Israeli parliament in 2008, namely “the transplantation law” and “the brain-respiratory death law”. The first law included a clause prohibiting organ sale and trafficking which practically outlaws organ tourism and prohibits health insurance reimbursement for live-donor kidney transplantation performed abroad. Another clause in that law ensures donor compensation for loss of earnings, refund for rehabilitation after donation and psychological consultation, as well as a 5-year reimbursement for health and life insurance. The second law clearly defined “brain-respiratory death” as actual death for all legal and halachic purposes and outlined the procedures required to perform determination. We examined the number of transplants and consent rate before and after these two laws were implemented. Results: During 2011 we have observed a significant increase in the number of kidney transplantations (picture 1) performed from both deceased (77% increase) and living-donors (32% increase) and also a significant increase in the consent rate for deceased-donation, from 49% in 2010 to 55% in 2011Figure: [Mor Kidney Tx]Figure: [Mor consents]Conclusions: current national and international policies prohibiting organ tourism and application of legal initiative to promote local donation are important factors responsible for the increase number of kidney transplantation in Israel.