Ruling Concerning donating and transplantation of organs

The Prophet (Salla Allaahu ‘alaihi wa sallam) said: “Breaking off the dead person’s bone is like breaking it off while he is alive.” [Related by Ahmad (24218)]

However, problems have arisen as a result of some fatawa (legal opinions), which consider organ donation to be permissible. These fatwas have caused people in some countries to kill their children and sell their livers or kidneys, which has happened in countries other than our country [Saudi Arabia], praise is due to Allah, since people in our country fear Allah. But if this had been forbidden internationally, and those who did it would be punished, this thing would not happen.

Some people say: “My father has renal failure, and I have two good active kidneys of which I want to give him one so maybe he will survive.” We would tell him: “This is unlawful and not permissible. If your father were starving in the desert, would he be obliged to eat your flesh and would you tell him to cut your thigh and eat it? This is indeed unlawful; although you might not be harmed as a result of this,  because you have, for example, machines to immediately prevent bleeding and accordingly there will be no risk of death.”

So it is important that, even if some people find it something good, we do not ever agree with it even if the donation was from a disbeliever. Also, our scholars –may Allah have mercy on them- mentioned this in the chapter entitled ‘Funerals’, and the author of “Sahib al-iqna’a” mentioned it in ‘Washing the dead’, where he said: “It is unlawful to take an organ from the dead for another person, even if he donated it.” Glory be to Allah, as if they lived in our era, may Allah have mercy on them.

And if one said: “How do you make blood donation lawful and at the same time you do not legalize the donation of organs?

The answer is that blood is immediately replaced by other blood, thus because of that they order the one who donates his blood to eat and drink to compensate for what was taken from him. However, an organ is not compensated for.

If someone said: “How about if the organ was extra, like a man with three kidneys, if such thing existed?”

We say: “Even if it existed we say that it is unlawful because Allah Almighty has wisdom in creating these three kidneys. As for donating a part of the liver, if the liver will regenerate what was taken from it – if this is scientifically proven – and there was a person in need, we may say, it is like blood donation.

However, if that organ is an extra finger for example, the person can then have an operation to remove it, and if someone can benefit with it, then there is no harm.” [Sharh Bulugh al-Maraam-Book of Siyam]

Shaikh Ibn Baaz (Rahimahullaah) was asked the following question:

 A friend of mine donated her kidney to her brother, who was suffering from kidney failure. She was told, however, that what she was doing was unlawful, unlawful because the body we have been given is a trust, and we will be asked about that trust on the Day of Judgement.

He (Rahimahullaah) answered: “If the doctors that specialized in that field decided that she would not be harmed by the removal of her kidney, and if they believed that kidney to be of use to her brother, there is nothing wrong with what she did. On the contrary, she will be rewarded – if Allaah wills – because she helped to save another human being; Allaah Almighty says:

وَأَحۡسِنُوٓاْ‌ۛ إِنَّ ٱللَّهَ يُحِبُّ ٱلۡمُحۡسِنِينَ

“And do good. Truly, Allah loves the doer of good.” [Al-Baqarah 2:195]

And the Messenger of Allah (Salla-Allahu ‘Alayhi wa-Sallam) said, “Allaah Almighty helps His servant as long as His servant helps his brother.”

” والله في عون العبد ما كان العبد في عون أخيه”

 [Muslim no. 2699]

And with Allaah is the facilitation to do what is right.

Risk of kidney transfer 

However, the latest research proved that there are many risks especially in kidney donation, as is explained in the following research presented by the Egyptian Society of Medical Ethics. 

First: the risk to a healthy person as a result of kidney donation in one of the most serious loss of functional kidney Reserve and turn to the so-called medical (patient potential renal failure):

Some doctors deliberately hide the damage and risk (short-term and long-term) that occur for the donor for fear of the escape of the donor or his hesitance in donating. Indeed, some senior Doctors of kidney in Egypt deliberately hide those damages to promote kidney transplant claim that human needs only a quarter of his kidney and can dispense with one of the kidneys without any damages or problems. In fact, the double organs in the human body is not redundant or extra, but rather it is functionally integrated to perform the functional needs of the body, a so-called medically (reserve job of the kidneys) and identifies the importance of this reserve job when the body is exposed to cases of physiological or pathological, which requires the work of a larger number of units of excretion in kidneys. As well as with human progress in the age where also needs to work a larger number of units of secretion due to the low efficiency of these units when aging. Thus, the loss to one of the two kidneys require medical follow-up and put a strict diet and avoid certain medications that may impair (harm) kidney function and conduct regular tests for kidney function. Medical References identify follow-up period for the person who donated one of his kidneys to be from 30-40 years. Also they define the precautions to be followed by the donor as says Brenner in THE KIDNEY, Edition 1991.

Accordingly, the donor of a kidney should be followed up for a period of 30-40 years with regular tests for the function of kidney. In addition to putting the donor to a strict diet with determining the amount of protein that he should take throughout his life for the prevention of exposure to kidney failure after donating. [Reference 1] (See the text of the statement in the documents).

Among the facts cited by medical references about the changes that occur in the remaining kidney for the donor and the necessity of following-up throughout his life for fear of suffering kidney failure are the following:

1- The reference “THE KIDNEY”¹BRENNER BM & RECTOR FC (1991) THE KIDNEY, VOL 2, 4 th EDITION. WB SAUDERS COMPANY P 2365.  mentions the details of the most important and most dangerous complications that is hidden from the donor of his kidney, a serious impact for the sudden  eradication of the sound kidney on the remaining other kidney. Where  in all cases (100%) inflation occurs in the tissues of the remaining kidney as an increasingly gradual stiffness happens in the units of secretion GLOMERULAR SCLEROSIS which results in a gradual increase in weakness in the function of remaining kidney, and may end in the long term (after many years) to renal failure (see text in documents).

2 – Saudi Journal of Kidney Diseases and Transplantation, the March 1995²Saudi Journal of Kidney Diseases and Transplantation of Shawwal, 1415, March 1995 – Multi (early changes in the size and function of the remaining kidney after donating one of the kidneys) Page 18 of / Faisal Abdul Rahim Al Shaheen and others confirms that the remaining kidney, after the donation process, is exposed to compensatory changes; its size increases by 15% after the first three months and the level of Creatinine increases in blood by 76% of donors also the Creatinine clearance is reduced by 36% after kidney donation process directly).

3 – The reference “THE SOLITARY KINDEY IN HEALTH AND DISEASE” explains the changes that occur for the donors of kidney which could end up probably in renal failure. It says that the units of secretion is influenced due to increased pressure in the capillaries by INCREASED CAPILLARY PRESSURE which lead to the emergence of albumin in the urine and fibrosis of the units of secretion, accordingly the blood pressure increases then the probable potential renal insufficiency.³RINK & ADAMS (1992) THE SOLITARY KIDNEY IN HEALTH & DISEASE AVA UPDATE SERIES. P274-9

4 – The doctoral thesis carried out on 277 of the of kidney donors in Mansoura (in Egypt) in 1994⁴OMHA M. 1994: LIVE DONOR NEPHRECTOMY: EVALUATION AND LONG- TERM FOLLOW UP. MD THESIS, UROLOGY, MANSOURA UNIVERSITY. shows the following: –

     a – High Creatinine ratio in the blood and low level of Creatinine clearance with kidney donors: This change was statistically significant high (HIGHLY SIGNIFICNAT DIFFERENCE).

    b – A rise in blood pressure as a result of kidney donation: 19.9% ​​of kidney donors at the Center of Mansoura suffered of increased blood pressure (meaning that one out of every five of the donors is infected with high blood pressure). Compared to the western studies on the complications of kidney donation, on the long run, we find that the increased in blood pressure reaches with 60% of the kidney donors to 100/150. [Delano et. al. 1993] .

    c – the descent of protein in urine after donating: in 28% of donors of kidney at the center of Mansoura and compared to the results got from western studies for the descent of protein in urine of kidney donors in the long run:

39% of donors. [MILLER et al. .1985]

32% of donors. [WILLIAMS et. al .. 1986]

5 – In the light of these risks about the potential deterioration of the function of the remaining kidney as a result of donation, the Saudi Journal of Kidney Diseases and Transplantation number March 1995 Page 18⁵Saudi Journal of Kidney Diseases and Transplantation of Shawwal, 1415, March 1995 – Multi (early changes in the size and function of the remaining kidney after donating one of the kidneys) Page 18 of / Faisal Abdul Rahim Al Shaheen and others confirms that one must follow the donors for a long time to make sure the impact of donation on the remaining kidney in the long term.

Sources:

     Fatawa Islamiyyah, vol 8, pages 225-229.

     Sharh Kitaab Bulugh al-Maraam- Book of Siyaam, by Shaikh Ibn ‘Uthaimeen

     www.medethics.org.eg/esme/dangers1.htm