Medical experts urge reform of Malaysia’s organ transplant system, citing policy gaps and shortage of specialists.
PETALING JAYA: The medical fraternity has sounded the alarm over the country’s stagnant organ transplant situation, adding that persistent gaps in policy, manpower and governance are driving patients abroad for life-saving surgeries.
Malaysian Society of Transplantation (MST) president Dr Mohamad Zaimi Abdul Wahab said despite nearly five decades of transplant history, Malaysia continues to struggle to meet domestic demand, particularly for complex procedures such as paediatric liver transplants.
“Our transplant ecosystem as a whole is still not conducive for the growth of transplantation in Malaysia.
“Malaysia was one of the earliest nations in Southeast Asia to perform kidney transplants, dating back to 1975. Yet our progress has stagnated,” he told theSun in a phone interview.
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Between 1997 and 2025, Malaysia recorded only 161 liver transplants, far behind South Korea, which performed 310 in 2022 alone.
“That’s bad. For kidney patients, there’s dialysis. But for liver patients, if they don’t get a new organ, they die,” he said.
Zaimi added that under the 2008 Declaration of Istanbul – an international ethical framework against organ trafficking, which Malaysia has ratified – countries are expected to achieve “self-sufficiency” or the ability to meet transplant needs locally without sending patients overseas.
“The fact that Malaysians still travel abroad shows we haven’t achieved that goal,” he said.
He added that paediatric liver transplants remain among the most challenging due to limited expertise.
“Before Covid-19, paediatric liver cases were referred to China. Now, Hospital Tunku Azizah in Kuala Lumpur can perform them but there are still limitations on the complexity of cases they can handle.
“Malaysia has capable surgeons, but not enough dedicated full-time transplant specialists. When someone handles only two or three cases a month, it’s impossible to build consistent proficiency.”
Zaimi also criticised the absence of a national authority to coordinate transplant policy and capacity-building efforts.
“Unlike nephrology, which has a national head of service, there is no dedicated body overseeing transplantation in Malaysia.
“The National Transplant Resource Centre (NTRC) only promotes awareness and coordinates deceased-donor programmes.
“It’s even parked under Hospital Kuala Lumpur, not directly under the Health Ministry. A national-level body should never be placed under a hospital.”
He said for years, MST has proposed that NTRC be empowered as a full-fledged coordinating authority overseeing resource planning, governance and standards.
“There has been some movement, but it’s slow. We hope the ministry would move in that direction so there is one body with real authority to plan and ensure accountability nationwide.”
Meanwhile, experts from the Universiti Teknologi Mara Faculty of Medicine said the problem extends beyond logistics and infrastructure, involving ethics, trust and governance.
“From a bioethical view, organ transplants done overseas raise questions about consent, fairness and exploitation.
“Without stringent oversight, there is a risk that ethical and legal standards might be overlooked, including the potential for trafficking or the use of substandard organs.
“Saving a life must never come at the cost of human dignity or justice,” said associate professor Dr Aimi Nadia Mohd Yusof and Dr Muhamad Zaid Muuti in a joint statement.
The duo urged Malaysia to adopt transparent donor systems, enhance public awareness and invest in specialist training.
“Malaysia must first address the problem of low organ donation rates. At present, Malaysia uses an opt-in system, meaning people must sign up to become donors.
“By introducing a transparent, well-managed opt-out system, supported by education and public awareness, Malaysia can increase the number of available organs and reduce the need for patients to go overseas. This can cut long-term treatment costs, such as dialysis.
“Most importantly, people would still have the right to opt out if they are not comfortable donating. This change could make the system fairer, ethical and trustworthy.”
