Doha Donation Accord (DDA) on the trail of the Declaration of Istanbul (DOI); A local implementation of an international framework to improve Organ donation and combat commercialism .

Riadh A. Fadhil¹, Hanan Alkuwari¹, Yousef Almaslamani¹, Abdalla Alansari¹, Hassan Almaliki¹, Hatem Khalaf¹, Omar Ali¹

¹Qatar Organ Donation Center & Qatar Center for Organ Transplantation , Hamad Medical Corporation, Doha, Qatar

Qatar is a small Gulf state of 1.7million multicultural society(1), Renal Transplantation in Qatar started 1986, but the number of transplants remained low because of lack of donors that pushed most of the ESRD patients to seek commercial transplantation abroad and return back with high complications and mortality(2,3). All liver transplantations average 15/year, used to be done abroad.

In order to combat commercial transplantation and to develop organ donation and transplantation , HMC the main tertiary health care facility adopted the recommendations of DOI and WHO guiding principles, and extracted what is compatible from the Qatari laws and regulations to launch the  DDA in 2010 (4,5,6,7).

The Principles of the DDA include; Equity & Fairness in access to organs, Extra care of Donors and recipients, community education, development of Donor Registry. And no financial incentives to donors or families, instead it is a community focused removal of disincentives scheme   with the leaders' inspirational vision that poor and underprivileged communities will donate organs if they sense fairness, respect, dignity and freedom to donate(8).

 Since  the implementation of the DDA  early 2011  There has been increase in the consents rate  gradually to 3/year in 2010  ,and to  1 or 2/month since January 2013 , seekers of transplant abroad dropped 69% in 2012 , 80 % of the native ESRD ready for transplantation  have registered for transplant in Doha , Kidney transplants done abroad to those done in Qatar decreased tremendously in  2012 to 1/1  as compared to 30/1 in 2008 .No liver transplantation done abroad since April 2012, While four successful Liver transplantations were done in HMC  so far .

Conclusion: DDA has succeeded to increase organ donation ,and develop transplantation, We recommend it to countries that have comparable demography and socioeconomic status . local factors should be taken in consideration in implementing the DOI recommendations .