Health Ministry: Proposal Allows Under-15s to Donate Regenerative Tissue to Immediate Relatives

The press conference convened amid mixed public reactions regarding statutory provisions on tissue and organ donation by individuals under 18, as well as proposals to consult children aged 7 and older on donation. These debates center not only on the legal appropriateness of the rules, but also on mechanisms to protect children’s fundamental rights.

Deputy Minister Ha noted that this proposal draws on guidelines from the World Health Organization (WHO) and international precedents. The draft outlines stringent criteria prioritizing the child’s rights and best interests. Under these rules, living donations of vital solid organs from individuals under 18 remain strictly illegal. Living donation covers only regenerative tissue, such as hematopoietic stem cells, under narrow, explicitly defined exceptions.

Article 20 of the Council of Europe’s Oviedo Convention permits the donation of regenerative tissue to siblings under rigorous conditions: no compatible adult donor exists, and the minor donor raises no objection. Regarding post-mortem organ donation, 2023 data from the Council of Europe shows that numerous countries—including the United States, the United Kingdom, Germany, Australia, Italy, Thailand, and Malaysia—already permit deceased donations from minors under 18. Ha emphasized that this data provides a vital benchmark for the drafting committee to study, analyze, and assess suitability for Vietnam’s actual conditions, ensuring the necessary legal protections and safeguards.

The draft law broadens tissue donation categories by permitting living individuals to donate regenerative tissue like stem cells, blood, and plasma. Conversely, it strictly bans living donation of non-regenerative tissue, including corneas, sclera, and heart valves.

Under the specific statutory framework, individuals aged 18 and older may donate regenerative tissue. Minors aged 15 to under 18 may donate regenerative tissue—excluding whole blood and blood components—to family members when no compatible adult donor exists, subject to statutory underage protection requirements. Meanwhile, children under 15 may donate regenerative tissue, excluding blood and blood components, strictly to biological parents or biological siblings when no other suitable donor exists, provided all minor protection criteria are satisfied.

To safeguard young donors, the child must possess certified physical health, receive independent counseling, and give clear personal consent alongside approval from parents or legal guardians. Furthermore, retrieving tissue or organs from deceased individuals under 18 requires an independent medical board to verify brain death or circulatory death, accompanied by prior registration or direct parental or guardian consent.

Deputy Minister Vu Manh Ha speaks at the Ministry of Health press conference on the afternoon of October 27. 

The draft addresses a major legislative void. Current Vietnamese law prohibits individuals under 18 from registering as tissue or organ donors and lacks clear protocols for living regenerative tissue donation. Meanwhile, clinical demand for pediatric transplants remains acute.

Experts estimate that pediatric patients in Vietnam require approximately 55 liver transplants and 60 kidney transplants each year, with roughly 200 pediatric patients currently waiting for a liver match. Demand for hematopoietic stem cell transplants also vastly exceeds current clinical supply. For conditions such as acute leukemia, aplastic anemia, thalassemia, and congenital immune disorders, stem cell transplantation offers a decisive curative lifeline.

Prof. Dr. Nguyen Hoang Dinh, Deputy Director of the University Medical Center Ho Chi Minh City, stated that the hospital has completed 57 pediatric liver transplants. Among these, 50 received grafts from living donors—primarily parents—while seven came from brain-dead donors. In pediatric liver procedures, surgeons can split an adult liver graft, but this technique does not work across all organs. Dinh explained that surgeons cannot harvest a heart from a living donor or divide a heart to transplant into multiple recipients. Therefore, if the law permits deceased organ donation from individuals under 18 under strict protective conditions, more donor organs will reach pediatric patients waiting on transplant lists.

Prof. Dr. Tran Minh Dien, Director of the National Children’s Hospital, cited pediatric patients with severe thalassemia who require blood transfusions roughly every 20 days. Receiving a matched stem cell transplant from an immediate relative helps children reduce or eliminate reliance on lifelong transfusions. In select cases, doctors preserve umbilical cord blood from younger siblings to treat older siblings, occasionally supplementing it with bone marrow stem cells when compatibility and safety criteria are satisfied.

The National Children’s Hospital currently carries approximately 60 pediatric patients on its liver transplant waitlist. Among them, 25 face imminent death within the next three to five months without a transplant; 20 require surgery within six to eight months, and the remainder can wait roughly a year. Dr. Dien asserted that expanding deceased donor pools would boost survival chances for critically ill children while reducing health risks for relatives undergoing living donor procedures.

WHO Representative to Vietnam Angela Pratt addresses the Ministry of Health press conference on the afternoon of October 27. 

Addressing the proposal to consult children on the draft legislation, Dang Hoa Nam, Vice President of the Vietnam Association for the Protection of Children’s Rights, stated that consulting children during lawmaking is a mandatory requirement. However, methods must match their age and cognitive capacity. Children must receive clear explanations to grasp the issues, take in accurate details, and articulate their wishes honestly and independently.

Nam remarked that consulting children during the drafting of this law is a necessary condition, but it is not sufficient on its own to safeguard their supreme rights and interests. Even when a child and their parents or guardians grant consent, the final determination must rest on rigorous clinical evaluations and statutory safeguards to prevent harm to the child’s long-term health and development.

Nam proposed that alongside an independent medical board, child psychologists or experienced social workers must participate in the assessment process. These experts can determine whether a child’s stated wish is genuinely voluntary and objective, or shaped by manipulation, persuasion, or family coercion. He stressed that a child’s voice must represent their genuine, uncoerced perspective, entirely free from manipulation or exploitation, noting that widening donor criteria must go hand in hand with maximum safeguards.

Regarding this issue, Deputy Minister Ha confirmed that the draft integrates mechanisms to monitor procedures and eradicate tissue and organ trafficking targeting minors. These safeguards require personal consent from the child alongside approval from parents or natural guardians pursuant to Article 52 of the Civil Code. They restrict living donors aged 15 to under 18 to family members, and limit living donors under 15 to biological parents and siblings. The Ministry of Health will continue studying a narrower framework that limits under-15 donation exclusively to biological siblings. The ministry will also issue independent counseling protocols to guarantee donors receive comprehensive information, choose voluntarily, and face zero coercion. A child’s dissent or refusal at any stage or moment will be fully honored and documented.

Press conference at the Ministry of Health regarding the draft amended Law on Donation, Removal, and Transplantation of Human Tissues and Organs and Donation of Cadavers on the afternoon of October 27. 

Attending the conference, WHO Representative to Vietnam Angela Pratt evaluated the draft law as broadly aligned with WHO ethical principles and global best practices. She noted that continued refinements remain vital, particularly regarding age-appropriate disclosures and informed pediatric consent. She supported expanding tissue and organ donation avenues for children in Vietnam, provided child welfare remains the core priority backed by strict protective oversight.

Pratt shared that no parent wishes to see their child in a position needing an organ transplant or donating one, but should that happen, a system ensuring clear, equitable, and safe ethical standards is essential. She noted that Australia permits minors to register post-mortem donation wishes via a voluntary registry, accompanied by family involvement, professional clinical assessments, and independent oversight, with several other nations applying comparable regulatory frameworks.

Concluding the briefing, Minister of Health Dao Hong Lan stated that the draft bill is undergoing final refinements before submission to the National Assembly for consideration at the second session of the 16th National Assembly. The Ministry of Health will review and incorporate feedback from deputies, the public, medical experts, and media outlets with an open and receptive approach.

According to Minister Lan, the 2006 law created a foundational legal framework for clinical transplantation across Vietnam. However, after 20 years of enforcement, the statute reveals operational gaps amid rapid advances in medical technology. Meanwhile, transplantation remains the sole curative lifeline for patients suffering from end-stage organ failure, and pediatric waiting lists continue to swell. She emphasized that authorities cannot stand idle when clinical solutions exist to save dying patients, noting that the duty of legislators is to improve legal mechanisms to maximize public benefit while guaranteeing that no citizen faces coercion to donate organs.

The Minister affirmed that the draft rests on two core pillars: expanding clinical opportunities to save lives and tightening protective requirements for prospective donors. Broadening donor criteria must run parallel with strict statutory eligibility standards, defined beneficiary classes, and explicit statutory prohibitions to prevent coercion, illicit organ trading, and commercial exploitation.

The Minister acknowledged that public concerns regarding pediatric organ donation require clear, transparent communication. Technical ambiguities within the text will undergo rigorous legal revision to safeguard children’s rights and verify clinical feasibility. Minister Lan stressed that the draft bill’s goal is to expand life-saving options for patients while delivering a solid legal shield that allows medical teams to operate with full confidence.

Minister of Health Dao Hong Lan addresses the press conference on the afternoon of October 27. 

Earlier on October 21, Minister Lan, authorized by the Prime Minister, presented the draft bill to the National Assembly. The draft law continues to gather parliamentary and public input before legislative voting at the second session of the 16th National Assembly.

The draft bill comprises seven chapters and 39 articles. It introduces provisions governing donor registration for individuals under 18, differentiating living regenerative tissue donation under special clinical exceptions from post-mortem deceased donation following verified brain death. Underage prospective donors must secure written approval from parents or legal guardians, retaining the unilateral right to amend or withdraw their registration at any time.

Source: vnexpress.net