Cayman’s health facilities are still in a holding pattern when it comes to performing organ transplants, despite the fact that government has passed laws and regulations regarding the procedure.
Cayman’s Legislative Assembly passed the Human Tissue Transplant Law in 2013 and the Human Tissue Donation and Transplant Regulations in 2018, and both are currently in effect.
A Human Tissue Transplant Council was formed last August in accordance with the Transplant Law. But despite some progress on the legislative front, there’s still work to be done before Cayman patients can have transplants performed locally, said Jennifer Ahearn, chief officer of the Ministry of Health.
“Given the significant medical and social complexities associated with tissue transplant procedures, the Ministry has been collaborating with the chair and deputy chair to develop a framework to guide the operations of the Council and prioritise their work,” said Ahearn via email.
She said the council’s responsibilities include oversight of the import and export of human tissue, establishing a donor registry, and the issuance of a permit or licence to authorised facilities for human tissue transplant.
“The Ministry believes that it is essential that we develop this process in a manner that ensures the highest standards of care, safety and quality for our community, as well as any patient visiting these shores,” she added. “At the same time, we are very conscious that many people in the community are looking ahead to a time when they and their loved ones will be able to benefit from these procedures without leaving the Cayman Islands, or register as organ and tissue donors to benefit others after they have passed on.”
The Human Tissue Transplant Council, which is chaired by attorney Gina Berry, includes Dr. Diane Hislop-Chestnut, heart transplant survivor Robert Hamaty, Reverend Nicholas Sykes and a chosen delegate of the Commissioner of Police. It has met just once since its formation, and its members are appointed until August 2020. Ahearn said that it could be as long as a year before the council is fully operational.
“While a timeline for the Council to become fully operational has not yet been agreed upon,” said Ahearn on behalf of the Ministry of Health, “it is expected to be about another 12 months when we hope to work with facilities that will be licensed to operate as tissue banks and making provisions for the donation of tissue from living persons or removal of tissue from deceased persons”.
The Human Tissue Transplant Law stipulates that the council’s job is to advise the ministry on policy, as well as monitor the donation of tissue by living individuals and the removal of tissue from deceased people. The council also has the remit to regulate and supervise any business carried out in the Cayman Islands regarding the purchase of tissue and the right to take tissue from bodies.
Hamaty, who underwent a heart transplant more than two decades ago, said that Cayman would be the first Caribbean island to establish an organ procurement programme, and he stressed the importance of getting everything right before its enactment. Due diligence, he said, will take time and effort.
“As soon as that chairman calls a meeting, we’ll attend,” he said of the Human Tissue Transplant Council. “There’s a lot of legality involved. There’s things that have to happen, but it’s happening.”
And while the wheels are turning on the other end, local health providers are getting ready.
Cayman’s hospitals are gearing up to meet the demand for transplants locally. Dr. Delroy Jefferson, chief medical officer for the Health Services Authority, said that is the next frontier.
“It clears the way for local facilities to do transplants,” said Jefferson of the Human Tissue Transplant Law and the corresponding regulations. “We’ve not done any, because the facility has to have that function – the equipment, the operating room. If we’re going to do renal transplant or liver transplant, that’s outside the scope of our services now. But we have qualified transplant physicians on staff.”
Dr. Binoy Chattuparambil, the chief cardiac surgeon at Health City Cayman Islands, said that everything is in place for his hospital to perform kidney transplants as soon as the legal red tape has been cut through.
“If that transplant law is done, we’re ready to start with kidney transplants,” he said. “Once the kidney transplants start, within six months, we’ll start with a cardiac transplant program. Then liver transplants. We have the current personnel. Everybody is there. We have a kidney transplant surgeon, a cardiac transplant surgeon and a liver transplant surgeon recently joined also. We have all the manpower.”