Regulation of Organ Transplantation in Thailand: Does it Work?

End stage organ failure is very distressing condition. Initially, there was only palliativetreatment for end stage organ failure such as hemodialysis or peritoneal dialysis. Later on, the advancement of immunosuppressive drugs, surgical techniques and medical diagnostic devices gave hope for end stage organ failure patients (1, 2). With organ transplantation the failing organ is replaced with a functioning one. The results are very impressive; the 1-year survival rate was 93-98% and 5-year survival rate was 73-82% compared to those of hemodialysis and peritoneal dialysis, 78% and 29% respectively (3). Patients can function almost normally in their daily activities, play sport and do some hard work. There are also benefits for good mental health and social relationships (2, 4). In developed countries, organ transplantation is currently considered a well-established treatment for irreversible renal, cardiac and liver failure, as well as for some respiratory diseases (5). Although the operative costs and the immunosuppressive drugs are very expensive, in the long term, the total cost of kidney transplantation is lower than that of hemodialysis and peritoneal dialysis (6, 7).[HEFP WP NO 04/03]