kidney transplant and age

Health Correspondent THE number 60 is a critical one for kidney patients.

A patient is taken off the queue for a cadaveric kidney under the Human Organ Transplant Act (Hota) when he turns 60 years of age.

Hota also has another caveat: Kidneys cannot be harvested from the bodies of those who die above the age of 60, unless their families agree.

So it works both ways: Above 60 and no cadaveric kidney for you. And no kidney can be automatically taken from an over-60 who has died.

Underpinning the latter is the supposition that it would be morally wrong to take a kidney from an older person, while not giving someone of a similar age the chance to get a kidney in return.

If not for the law, how many people in Singapore would need a transplant and how many organs would actually be available? Or, in market terminology, what's the true demand and supply situation?

The queue for a cadaveric kidney stood at 563 last year, and anecdotal evidence suggests that it could be twice as long if the above-60s joined it.

Why 60?
One guess: The state does not want to have a large number of older people queueing for the limited number of kidneys that become available each year. Only 47 cadaveric kidneys were harvested last year.
The desire to skew priority for cadaveric kidneys in favour of younger patients is understandable, since they have longer lives ahead of them.
But what if cadaveric donors above 60 were included? The chances are the pool of cadaveric kidneys available here would balloon to 63 - or 16 more a year.
The cut-off age for other organs is different, largely because of the shorter waiting list and because patients who don't get an organ within months usually die.
Hota allows cadaveric hearts to go to people up to the age of 65, and cadaveric livers to patients as old as 70. Waiting times for these organs range from two to five months.
Some have called for the removal of the age cap for cadaveric kidneys. Spain, which has a very robust cadaveric transplant programme, gets a third of its kidneys from people over the age of 60.
There is no reason why Singapore cannot do the same and give older kidney patients hope.
One worry is that kidneys taken from older cadavers might not be of very high quality. If so, why not divide potential recipients into two age-based groups?