Implementation of Amendments to the Human Organ Transplant Act(HOTA)

25 Jun 2009

To save more lives by increasing the number of organs available for transplant, the Ministry of Health (MOH) will be lifting the upper age limit for deceased organ donation under the Human Organ Transplant Act (HOTA) from 1st November 2009.

Other amendments to HOTA - donor-recipient paired matching for organ exchange and transplant, allowing for reimbursement to living donors for the costs associated with the donation, and increased penalties for organ trading, will similarly be deemed to be implemented from November this year.  However, where the amendments involve implementation which are administrative in nature and can be carried out earlier, we will do so.

These amendments were approved by Parliament in March this year, after extensive public consultation and Parliament debate.

Removal of upper age limit for deceased organ donation

Currently, HOTA limits cadaveric donors to those between 21 to 60 years of age. However, with increasing life expectancy, healthier ageing and improvement in health technology, older persons can also be suitable donors. Other countries do not set an upper age limit for deceased organ donation.

Thus, to further increase organ donation rates, the upper age limit of 60 years will be removed from 1st November 2009 and all Singapore Citizens and Permanent Residents, who are 21 years old and above and of sound mind will be included under HOTA unless they have opted out. An estimated increase of up to 10 to 12 organ donors is expected per year, which could potentially benefit 70 more patients each year. There will also be no upper age limit for the kidney transplant waiting list.

To ensure best transplant outcomes, evaluation of donated organs will be according to strict medical criteria, and allocation of organs from older donors will depend on clinical parameters, such as matching factors (blood group, tissue type), and medical fitness of the potential recipients.

Saving more lives and protecting donor welfare

Paired matching is a way of matching living donors with compatible recipients across two or more donor-recipient pairs who are incompatible within the pair. With paired matching, more patients will be able to have a transplant. Paired matching will also enable better medical compatibility in donor-recipient matches for improved transplant outcomes.

To protect the welfare of living donors, HOTA will also allow for payment to altruistic living donors, only for reimbursing or defraying the costs or expenses that may be reasonably incurred as a result of organ donation. This will include costs for health checks, laboratory tests, surgery and hospitalisation, follow-up visits and verifiable loss of earnings due to organ donation.

Lastly, to protect donors and recipients from exploitation by unscrupulous middlemen, penalties for organ trading will be increased and any person involved in the buying and selling of organs shall be liable to a maximum fine of $100,000 or a maximum imprisonment term of 10 years or both.

Public Education

To inform the public on the implementation of the HOTA changes, MOH will be launching a publicity campaign in July. The public will be informed via advertisements on mass media, including print and radio.

An information booklet with FAQs in the four official languages will also be sent to all households. The public can learn more about organ donation and HOTA through the detailed booklet.

Organ donation can help save lives, and the public is encouraged to spread the message by sharing their decision with their family. 

MINISTRY OF HEALTH, SINGAPORE