(SINGAPORE) The government is planning to amend the Human Organ Transplant Act (Hota) in an effort to allow more people to undergo transplants.

This includes scrapping the age limit of 60 years for deceased donors, and helping to matchmake living persons who want to donate their kidney to a family member but cannot do so because of incompatible tissue with other pairs of living-related donors facing the same dilemma.

Speaking in Parliament yesterday, Health Minister Khaw Boon Wan also touched on the controversial issue of legalising kidney trading.

Mr Khaw did not rule out the possibility but stressed that there were major practical concerns to consider apart from the moral and ethical issues.

'Would it result in more or fewer kidney transplants? Would it shrink the current cadaveric and living altruistic donor pool of organs? Some studies have shown that with a system of paying for organs in place, the altruistic donations will simply dry up,' he said.

However, if altruistic donations cannot meet demand, Singapore should search for other solutions. 'We should not reject any idea just because it is radical or controversial,' said Mr Khaw.

But with or without legalising kidney trading, Hota and living-related kidney donations must be the 'predominant sources' of transplantation. And here, the proposed changes could make a major difference.

Mr Khaw noted how kidneys are currently taken only from people aged 60 or younger. But as he described it, this was an 'arbitrary limit' and has unnecessarily put many organs to waste.

'The suitability of the organ depends on its condition rather than the age of the donor. The condition of the kidney can be determined by the transplant doctor and that should be the criterion for determining if an organ is suitable.'

Removing the age limit under Hota 'will help save many more lives', he added, as he called for the House's support when a proposal to amend the Bill is put up at a later sitting.

In Spain, where there is no age limit, a third of the cadaveric kidneys are from people aged over 60. The country is also well known for its short list of patients waiting for transplants.

Meanwhile, for living-related kidney donation, Mr Khaw said that there were often cases of family members who wish to donate to their loved ones but could not do so because their tissues did not match.

However, some US and European hospitals have carried out 'pair-matched donations', something not done in Singapore before.

This involves matching a donor whose tissue is incompatible with the intended patient, with another pair in the same boat.

Mr Khaw said that his ministry is working on this idea to help meet the altruistic wishes of such living-related donors. A live-donor registry will be set up to facilitate this and may require the legal backing of Hota, he said.

'While we are not yet getting 200 kidney transplants a year, we have raised our transplant rate quite significantly. We are now 50 per cent sufficient, not bad compared to many other countries,' said Mr Khaw, adding that the government's latest initiatives will raise this to 70 per cent in the medium term.

Hota enables a person's kidneys, heart, liver and corneas to be donated when he dies, unless he has signed an opt-out form.

Muslims are currently excluded from Hota because of religious considerations but this ruling will be lifted from next month.

The health ministry will also review possible changes to current legislation to allow payments for donations from third parties such as those from the charity and religious sectors.

Under the proposal, which would need to be approved by Parliament to become law, patients would also get help in finding donors.

'Criminalising organ trading does not eliminate it. . . it merely breeds a black market.'

Organ trading is illegal here and, in the last month, five men were charged in connection with the offence, the first such cases here. Organ trading is illegal in all countries except Iran.