Human Organ Transplant Regulations 2004

Human Organ Transplant Act 1987

(Section 32)

Human Organ Transplant
Regulations 2004

2025 REVISED EDITION

(2 June 2025)

[1 July 2004]

Citation

1.  These Regulations are the Human Organ Transplant Regulations 2004.

Definitions

2.  In these Regulations —

“donor”, in relation to a living donor organ transplant, means the person from whom a specified organ is or will be removed for the purpose of its transplantation into the body of another living person;

“recipient”, in relation to a living donor organ transplant, means the person into whose body a specified organ is or will be transplanted.

Forms for Parts 2 and 3 of Act

3.—(1)  The form for authorising the removal of any organ from the body of a person under section 4(1) of the Act is Form 1 in the First Schedule.

(2)  For the purposes of section 8(1) of the Act —

(a) the prescribed form is Form 2 in the First Schedule; and

(b) a person who is unable to read or understand English may complete and submit an official translation of Form 2 in Malay, Mandarin or Tamil that is available on the specified website.

(3)  For the purposes of section 8(2) of the Act, the prescribed form is Form 3 in the First Schedule.

(4)  For the purposes of section 10(1) of the Act —

(a) the prescribed form is Form 4 in the First Schedule; and

(b) a person who is unable to read or understand English may complete and submit an official translation of Form 4 in Malay, Mandarin or Tamil that is available on the specified website.

(5)  For the purposes of section 10(2) of the Act, the prescribed form is Form 5 in the First Schedule.

(6)  In this regulation, “specified website” means the website at https://www.liveon.gov.sg.

Approval and appointment of transplant ethics committees

4.—(1)  For the purpose of enabling transplant ethics committees to be appointed under Part 4A of the Act —

(a) the licensee of a hospital must, with the approval of the Director‑General, establish a panel of not less than 3 persons, who must be medical practitioners employed or otherwise connected with the hospital; and

(b) the Director‑General must establish —

(i) a panel of medical practitioners; and

(ii) a panel of lay persons,

comprising the numbers of medical practitioners and lay persons, respectively, determined by the Director‑General.

(2)  A member of any of the panels in paragraph (1) is to be appointed for a term of not more than 2 years and —

(a) he or she may be re-appointed with the approval of the Director‑General; and

(b) his or her appointment may at any time be terminated by the Director‑General.

(3)  The licensee of a hospital must, when applying for the approval of the Director‑General under sub‑paragraph (a) of paragraph (1), submit to the Director‑General the names and curriculum vitae of the persons nominated for the panel referred to in that sub‑paragraph.

(4)  Subject to paragraphs (5) and (6), the licensee of a hospital must, from time to time as the circumstances may require, appoint a transplant ethics committee comprising —

(a) one member from the panel mentioned in paragraph (1)(a);

(b) one member from the panel mentioned in paragraph (1)(b)(i) who is not employed or otherwise connected with the hospital; and

(c) one member from the panel mentioned in paragraph (1)(b)(ii).

(5)  Where it comes to the notice of the licensee of a hospital in which any living donor organ transplant is intended to be carried out, whether from the information provided in the application form for the written authorisation of the transplant ethics committee of the hospital or otherwise, that —

(a) a prior application for written authorisation under section 15(1) of the Act has been made to a transplant ethics committee in respect of the same prospective donor and prospective recipient; and

(b) the transplant ethics committee mentioned in sub‑paragraph (a) has refused to grant written authorisation,

the licensee must —

(c) seek the approval of the Director‑General if the licensee desires to proceed with the appointment of a transplant ethics committee under paragraph (4); and

(d) decline to appoint a transplant ethics committee if the Director‑General does not grant his or her approval.

(6)  The licensee of a hospital may, with the approval of the Director‑General, appoint one or more additional members to the transplant ethics committee.

(7)  Subject to the provisions of the Act and these Regulations, a transplant ethics committee may make rules to regulate its own procedure.

(8)  The licensee of a hospital may, with the approval of the Director‑General, change the membership of the panel mentioned in paragraph (1)(a).

Procedures of transplant ethics committees

5.—(1)  Every transplant ethics committee must assess and give its written assessment, in a timely manner, of an application for its written authorisation of a living donor organ transplant under section 15(1) of the Act.

(2)  The quorum of any meeting of a transplant ethics committee is 3 members, of whom —

(a) one must be a medical practitioner employed or otherwise connected with the hospital;

(b) one must be a medical practitioner not employed or otherwise connected with the hospital; and

(c) one must be a lay person,

and a decision must not be made unless such a quorum is present.

(3)  Subject to paragraph (6)(b), where an application for the written authorisation of a transplant ethics committee is assessed at a meeting of the transplant ethics committee, a person —

(a) who is directly involved in the care of the donor or the recipient; or

(b) who will be involved in the removal of any specified organ from the body of the donor or the transplantation of the specified organ to the body of the recipient,

must not be present at the meeting.

(4)  A decision at any meeting of a transplant ethics committee must be adopted by a consensus of the members present.

(5)  Every transplant ethics committee must —

(a) submit a copy of the report of every decision made by it in authorising any living donor organ transplant or otherwise to the Director‑General within 7 days of the date of the decision; and

(b) keep and maintain every report referred to in sub‑paragraph (a).

(6)  A transplant ethics committee may, when assessing any application for the written authorisation of a living donor organ transplant —

(a) request for any additional information or document to be provided by the applicant that it may consider necessary; or

(b) interview the donor, the recipient or any other person in relation to the application.

Additional considerations for giving of written authorisations

6.  Every transplant ethics committee must, in addition to the considerations specified in section 15(2) of the Act, have regard to the considerations of public interest and community values when assessing an application for its written authorisation of a living donor organ transplant.

Review of decisions by transplant ethics committee

6A.—(1)  An applicant for review who is aggrieved by the decision of a transplant ethics committee to refuse to grant written authorisation under section 15(1) of the Act may make a written application to the Director‑General to require the transplant ethics committee to review its decision.

(2)  The applicant for review must make the written application to the Director‑General —

(a) within a period of 21 days after the date on which the decision of the transplant ethics committee first comes to the notice of the applicant for review; or

(b) within any further period that the Director‑General allows, either before or after the end of that 21‑day period.

(3)  The applicant for review must, in his or her written application to the Director‑General, set out the grounds on which he or she is applying to the Director‑General to require the transplant ethics committee to review its decision.

(4)  Upon receipt of the written application, the Director‑General may, as he or she sees fit —

(a) dismiss the application; or

(b) direct the transplant ethics committee to review its decision, and specify the considerations that the transplant ethics committee must have regard to, as directed by the Director‑General under section 15(3) of the Act.

(5)  In this regulation, “applicant for review”, in relation to a living donor organ transplant, means —

(a) the person who made the application for the written authorisation of a transplant ethics committee under section 15(1) of the Act;

(b) the prospective donor; or

(c) the prospective recipient.

Period of validity of written authorisation

6B.—(1)  For the purposes of section 15(1) of the Act, every written authorisation of the transplant ethics committee of a hospital is valid for the period of time determined by the transplant ethics committee, not being a period longer than 60 days from the date the written authorisation is granted.

(2)  Upon the expiry of the validity period of a written authorisation as determined by the transplant ethics committee of a hospital in accordance with paragraph (1), a living donor organ transplant must not be carried out in the hospital involving the same prospective donor and prospective recipient except within the validity period of a fresh written authorisation of the transplant ethics committee of the hospital.

Forms for Part 4A of Act

7.—(1)  The form for applying for the written authorisation of a transplant ethics committee under section 15(1) of the Act —

(a) must be in Form 1 in the Second Schedule; and

(b) must be made by the medical practitioner who is principally responsible for the care of the donor.

(2)  The form for authorising, or otherwise, the removal of a specified organ from the body of a living person by a transplant ethics committee under section 15(1) of the Act must be in Form 2 in the Second Schedule.

Offence

8.  Any person who makes any declaration or statement in relation to an application for the written authorisation of a transplant ethics committee under section 15(1) of the Act which is false or misleading in a material particular shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $2,000 or to imprisonment for a term not exceeding 12 months or to both.

FIRST SCHEDULE

Regulation 3

FORM 1
HUMAN ORGAN TRANSPLANT ACT 1987
AUTHORISATION FOR REMOVAL OF ORGANS AFTER DEATH UNDER SECTION 4(1)
*(a) I authorise the removal of the *kidneys/liver/heart/corneas of the deceased named ____________________________________________, NRIC No. __________________ for transplantation to the body of a living person.
*(b) I do not authorise the removal of the *kidneys/liver/heart/corneas of the deceased named ____________________________________________, NRIC No. __________________ for transplantation to the body of a living person for the following reason(s):
__________________________	__________________________
Name of Designated Officer	Hospital
__________________________	__________________________
Signature	Date
* Delete whichever is inapplicable
MD141B

FORM 2
Front
	For official use only
HUMAN ORGAN TRANSPLANT ACT 1987
OBJECTION TO ORGAN REMOVAL UNDER SECTION 8(1)
(This form may take you 5 minutes to fill in. Please complete all particulars in BLOCK LETTERS.)

FULL NAME (as in NRIC)

NRIC

CITIZENSHIP/ RESIDENTIAL STATUS

□ Singapore Citizen □ Singapore Permanent Resident

DATE OF BIRTH

D

D

M

M

Y

Y

Y

Y

SEX

□ Male □ Female

RACE

□ Chinese □ Malay □ Indian □ Others (please specify)

HOME ADDRESS

POSTAL CODE

CONTACT NO.

I object to the removal of the following organ(s) for transplantation upon my death (please tick ‘√’ all applicable boxes): □ Kidney □ Liver □ Heart □ Cornea

Please note that under the Human Organ Transplant Act 1987: 1.  After registering your objection in respect of the organ(s) above, if you require a transplant of any such organ, you will be given lower priority as a proposed recipient compared to a person who has not registered an objection. 2.  You may withdraw your objection at any time. However, you will continue to be given lower priority as a proposed recipient, compared to a person who has not registered an objection, for 2 years after the date the Director‑General of Health receives your withdrawal.

SIGNATURE

DATE

D

D

M

M

Y

Y

Y

Y

WITNESS’ PARTICULARS*

FULL NAME (as in NRIC)

NRIC

DATE OF BIRTH

D

D

M

M

Y

Y

Y

Y

HOME ADDRESS

POSTAL CODE

CONTACT NO.

SIGNATURE

DATE

D

D

M

M

Y

Y

Y

Y

*Witness must be 21 years of age or older.

MD136

Reverse

Note:

1. This objection to organ removal only applies to individuals who are —

(a) Singapore Citizens and Singapore Permanent Residents; and

(b) 21 years of age or older.

2. This form is invalid if it is not duly completed.

3. Please forward the completed form to the following address:

National Organ Transplant Unit

c/o Singapore General Hospital

Outram Road

Singapore 169608

4. If you do not receive an acknowledgment to your objection to organ removal within 3 weeks, please contact the Officer-in-Charge at the above address or call Tel. No. 63214390.

FORM 3

Front

HUMAN ORGAN TRANSPLANT ACT 1987

REGISTRATION OF OBJECTION TO ORGAN REMOVAL
UNDER SECTION 8(2)

Name:

NRIC No.:

Reg. No.:

This is to certify that your name is in the Register of Objectors for:

MD136A

Reverse

For further information, please contact the National Organ Transplant Unit at Tel. No. 63214390 or at the following address:

National Organ Transplant Unit

c/o Singapore General Hospital

Outram Road

Singapore 169608

FORM 4
Front
	For official use only
HUMAN ORGAN TRANSPLANT ACT 1987
WITHDRAWAL OF OBJECTION TO ORGAN REMOVAL UNDER SECTION 10(1)
(This form may take you 5 minutes to fill in. Please complete all particulars in BLOCK LETTERS.)

FULL NAME (as in NRIC)

NRIC

CITIZENSHIP/ RESIDENTIAL STATUS

□ Singapore Citizen □ Singapore Permanent Resident

DATE OF BIRTH

D

D

M

M

Y

Y

Y

Y

SEX

□ Male □ Female

RACE

□ Chinese □ Malay □ Indian □ Others (please specify)

HOME ADDRESS

POSTAL CODE

CONTACT NO.

I withdraw my objection to the removal of the following organ(s) for transplantation upon my death (please tick ‘√’ all applicable boxes): □ Kidney □ Liver □ Heart □ Cornea

Please note that under the Human Organ Transplant Act 1987: After you have withdrawn your objection in respect of the organ(s) above, if you require a transplant of any such organ, you will continue to be given lower priority as a proposed recipient, compared to a person who has not registered an objection, for 2 years after the date the Director‑General of Health receives your withdrawal.

SIGNATURE

DATE

D

D

M

M

Y

Y

Y

Y

WITNESS’ PARTICULARS*

FULL NAME (as in NRIC)

NRIC

DATE OF BIRTH

D

D

M

M

Y

Y

Y

Y

HOME ADDRESS

POSTAL CODE

CONTACT NO.

SIGNATURE

DATE

D

D

M

M

Y

Y

Y

Y

*Witness must be 21 years of age or older.

MD137

Reverse

Note:

1. This withdrawal of objection to organ removal only applies to individuals who —

(a) are Singapore Citizens and Singapore Permanent Residents;

(b) are 21 years of age or older; and

(c) have previously registered their objections to organ removal.

2. This form is invalid if it is not duly completed.

3. Please forward the completed form to the following address:

National Organ Transplant Unit

c/o Singapore General Hospital

Outram Road

Singapore 169608

4. If you do not receive an acknowledgment to your withdrawal of objection to organ removal within 3 weeks, please contact the Officer-in-Charge at the above address or call Tel. No. 63214390.

FORM 5
HUMAN ORGAN TRANSPLANT ACT 1987
ACKNOWLEDGMENT OF WITHDRAWAL OF OBJECTION TO ORGAN REMOVAL UNDER SECTION 10(2)
Date:
Reg. No.:
NRIC No.: Sxxxx123A
<NAME>
<BLOCK>
<STREET>
<POSTAL CODE>
Dear Sir/Madam,
WITHDRAWAL OF OBJECTION TO ORGAN REMOVAL UNDER SECTION 10(1) OF THE HUMAN ORGAN TRANSPLANT ACT 1987
1. Your withdrawal of objection to organ removal under section 10(1) of the Human Organ Transplant Act 1987 (“HOTA”) has been received on <date>.
2. The current status of your objection to organ removal in the Register of Objectors is as follows:
Organ	Date of Objection	Date of Receipt of Withdrawal	Current Status
Kidney
Liver
Heart
Cornea
3. Please note that under section 11(b) of the HOTA, after you have withdrawn your objection in respect of the organ(s) above, if you require a transplant of any such organ, you will continue to have lower priority as a proposed recipient, compared to a person who has not registered an objection in respect of any such organ(s), for 2 years after the date of receipt of your withdrawal in respect of that organ(s).
4. Therefore, you will have priority to receive a transplant for any organ(s) specified in paragraph 2 over a person who has registered any objection in respect of that organ(s) only starting from <date>.
5. If you require further clarifications, please contact the National Organ Transplant Unit at 63214390 or [email protected].
Thank you.
Yours faithfully
[Name of Officer-in-Charge]
[Designation]
National Organ Transplant Unit
for Director‑General of Health
MD137A

SECOND SCHEDULE

Regulation 7

FORM 1

HUMAN ORGAN TRANSPLANT ACT 1987

APPLICATION FOR WRITTEN AUTHORISATION OF
LIVING DONOR ORGAN TRANSPLANT

All applications for written authorisation of living donor organ transplant must be made using this form.

The application for the written authorisation of a living donor organ transplant must be made by the medical practitioner who is principally responsible for the care of the prospective donor.

Particulars of prospective donor	Particulars of prospective recipient1
Name: ________________________ NRIC No./Passport No.: __________ Nationality: ____________________ Date of birth: ___________________	Name: ________________________ NRIC No./Passport No.: __________ Nationality: ____________________ Date of birth: ___________________

Medical practitioner for prospective donor	Medical practitioner for prospective recipient1
Medical practitioner who is principally responsible for the care of the donor: _____________________________ Surgeon who will be principally involved in the removal of the organ (if different from above): _____________________________	Medical practitioner who is principally responsible for the care of the recipient: ______________________________ Surgeon who will be principally involved in the transplant of the organ (if different from above): _____________________________

¹ For cases of paired donation, this refers to the recipient of the prospective donor’s choice. In this form, “paired donation” refers to the donation by a living donor (Donor A) of any organ from his/her body in consideration of —

(a) a donation of an organ from another living donor for the purpose of the transplantation of the organ to the body of a living recipient of Donor A’s choice (Recipient A); or

(b) priority in the selection of Recipient A as a recipient of any organ, whether removed pursuant to section 4 of the Act or otherwise.

Section I — Declaration by medical practitioner principally responsible for the prospective donor

I DECLARE THAT:

1. I am the medical practitioner principally responsible for the care of the prospective donor who has signed Section II of this form.

2. I have explained to the prospective donor the nature of the medical procedure and the risks involved in the removal of *his/her *kidney/part of *his/her liver.

3. So far as I am aware, the declarations that *he/she has made are true and I witnessed *his/her signature to Section II.

4. I have checked with the prospective donor and the prospective donor has confirmed that he/she

□ has not been previously reviewed by a transplant ethics committee

OR

□ has been previously reviewed by a transplant ethics committee, and the application was:

□ approved

□ rejected

□ others: _________________________________

(please tick relevant boxes)

5. I have checked with the prospective recipient and the prospective recipient has confirmed that he/she

□ has not been previously reviewed by a transplant ethics committee

OR

□ has been previously reviewed by a transplant ethics committee, and the application was:

□ approved

□ rejected

□ others: _________________________________

(please tick relevant boxes)

6. I am not aware of, nor do I have any knowledge of, any fact, circumstances or occurrence which may indicate or suggest that the prospective donor or any other person has been offered or given any valuable consideration, or has been offered or become involved in any contract or arrangement, for the prospective donor to consent to the removal of his/her organ.

□  Agree    □ Disagree      (please tick relevant box)

7. Based on my evaluation, the consent of the prospective donor:

(i) *is/is not given pursuant to any contract or arrangement; and

(ii) *is/is not given or obtained by virtue of any fraud, duress or undue influence.

8. I apply for the written authorisation of a living donor organ *transplant/paired donation involving the abovementioned prospective donor and prospective recipient to be carried out.

_________________________

_________________________

Signature

Date

_________________________

_________________________

Name and qualifications

MCR number

_________________________

Hospital and clinic

*Delete whichever is inapplicable.

Any person who makes any declaration or statement in relation to an application for the written authorisation of a transplant ethics committee under section 15(1) of the Human Organ Transplant Act 1987 which is false or misleading in a material particular shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $2,000 or to imprisonment for a term not exceeding 12 months or to both.

Section II — To be completed by prospective donor

Name: ___________________________________________________

*NRIC No./Passport No. and country of issue: ___________________

Permanent home address: ___________________________________

I wish to donate *my kidney/part of my liver for transplant to: _______

(In case of paired donation²) I wish to donate *my kidney/part of liver in consideration of a donation of *kidney/part of liver from another living donor for transplant to: ____________________________________

Name of recipient: ________________________________________

*NRIC No./Passport No. and country of issue: ___________________

² In this form, “paired donation” refers to the donation by a living donor (Donor A) of any organ from his/her body in consideration of —

(a) a donation of an organ from another living donor for the purpose of the transplantation of the organ to the body of a living recipient of Donor A’s choice (Recipient A); or

(b) priority in the selection of Recipient A as a recipient of any organ, whether removed pursuant to section 4 of the Act or otherwise.

I DECLARE THAT:

1.

I have been given an explanation of the nature of the medical procedure and the risks to me in the removal of *my kidney/part of my liver. That explanation was given by the medical practitioner principally responsible for my care named in Section I. The explanation was given *with/without a translator.

2.

I understand the nature of the medical procedure and the risks to me as explained by that medical practitioner.

3.

I consent to the removal of *my kidney/part of my liver.

4.

I have not been coerced in any way to give my consent for the removal of that organ.

5.

I did not give my consent pursuant to any inducement, contract or arrangement and I am not aware that any other person has been offered any form of inducement, contract or arrangement for me to give my consent to the removal of that organ.

6.

I understand that I will be required by the transplant ethics committee to declare, to the best of my knowledge, the existence of any contract or arrangement or valuable consideration, including those providing only for the defraying or reimbursing, in money or money’s worth, of the costs and expenses that may be reasonably incurred by me in relation to —

(a) the removal, transportation, preparation, preservation, quality control or storage of the organ;

(b) the costs or expenses (including the costs of travel, accommodation, domestic help or childcare) or loss of earnings so far as are reasonably or directly attributable to the donation of the organ from my body; and

(c) any short-term or long-term medical care or insurance protection which is or may reasonably be necessary as a consequence of the donation of the organ from my body.

7.

I understand that I may withdraw my consent to the removal of that organ at any time before the operation to remove *my kidney/part of my liver is carried out.

8.

I *have/do not have a well‑established emotional relationship with the recipient.

9.

□ I have not been previously reviewed by a transplant ethics committee.

OR

□ I have been previously reviewed by a transplant ethics committee, and the application was:

□ approved

□ rejected

□ others: _________________________________

(please tick relevant boxes)

10.

I understand that the information I have given on this form, any other information provided to the transplant ethics committee for the purpose of assessing this application, and the information on the outcome of the transplantation, may be stored on a computer system maintained by the transplant ethics committee or provided to the Ministry of Health.

Signature of prospective donor: _____________

Date: ____________

Signature of first witness: __________________

(Medical practitioner who is principally responsible for the care of the prospective donor)

Signature of second witness: ________________

Name: ________________

*NRIC No./Passport No.: __________

Relationship of translator to prospective donor: ____________________

(If a translator is required, the second witness must be the translator.)

Any person who makes any declaration or statement in relation to an application for the written authorisation of a transplant ethics committee under section 15(1) of the Human Organ Transplant Act 1987 which is false or misleading in a material particular shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $2,000 or to imprisonment for a term not exceeding 12 months or to both.

*Delete whichever is inapplicable.

Section III — To be completed by prospective recipient

Name: ___________________________________________________

*NRIC No./Passport No. and country of issue: ___________________

Permanent home address: ___________________________________

I wish to receive a kidney/part of a liver for transplant from: __________

Name of donor (if identified): _________________________________

*NRIC No./Passport No. and country of issue: ___________________

I DECLARE THAT:

1.

I have not offered any inducement, contract or arrangement nor am I aware that any other person has offered any form of inducement, contract or arrangement for the prospective donor to give his/her consent to the removal of his/her organ.

2.

I understand that I will be required by the transplant ethics committee to declare, to the best of my knowledge, the existence of any contract or arrangement or valuable consideration, including those providing only for the defraying or reimbursing, in money or money’s worth, of the costs and expenses that may be reasonably incurred by the donor in relation to —

(a) the removal, transportation, preparation, preservation, quality control or storage of the organ;

(b) the costs or expenses (including the costs of travel, accommodation, domestic help or childcare) or loss of earnings so far as are reasonably or directly attributable to the donation of the organ from the donor; and

(c) any short-term or long-term medical care or insurance protection which is or may reasonably be necessary as a consequence of the donation of the organ from the donor.

3.

I *have/do not have a well-established emotional relationship with the donor.

4.

□ I have not been previously reviewed by a transplant ethics committee.

OR

□ I have been previously reviewed by a transplant ethics committee, and the application was:

□ approved

□ rejected

□ others: _________________________________

(please tick relevant boxes)

5.

I understand that the information I have given on this form, any other information provided to the transplant ethics committee for the purpose of assessing this application, and the information on the outcome of the transplantation, may be stored on a computer system maintained by the transplant ethics committee or provided to the Ministry of Health.

Signature of prospective recipient: __________

Date: ____________

Signature of first witness: __________________

(Medical practitioner who is principally responsible for the care of the prospective donor)

Signature of second witness: ________________

Name: ________________

*NRIC No./Passport No.: __________

Relationship of translator to prospective recipient: ________________

(If a translator is required, the second witness must be the translator.)

Any person who makes any declaration or statement in relation to an application for the written authorisation of a transplant ethics committee under section 15(1) of the Human Organ Transplant Act 1987 which is false or misleading in a material particular shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $2,000 or to imprisonment for a term not exceeding 12 months or to both.

*Delete whichever is inapplicable.

FORM 2
HUMAN ORGAN TRANSPLANT ACT 1987
ASSESSMENT BY TRANSPLANT ETHICS COMMITTEE
Hospital: _________________________________________________
Organ to be transplanted: _____________________________________
Name of medical practitioner who is principally responsible for the care of the prospective donor: ____________________________________
Particulars of prospective donor	Particulars of prospective recipient
Name: ______________________________	Name: ______________________________
*NRIC No./Passport No.: _____________	*NRIC No./Passport No.: _____________
Date of Birth: _________________________	Date of Birth: _________________________
Sex: ________________________________	Sex: ________________________________
Race: _______________________________	Race: _______________________________
Nationality: __________________________	Nationality: __________________________

After taking all factors into consideration, the transplant ethics committee has decided to approve the application of organ *transplant/paired donation³ to be carried out:

□ between the abovenamed prospective donor and the abovenamed prospective recipient.

□ between the abovenamed prospective donor and a recipient (to be identified).

□ between the abovenamed prospective donor and the following recipient (name of recipient) _____________________________________________

(please tick appropriate box)

The transplant must be carried out within ____ (maximum of 60) days from the date of grant of written authorisation.

*After taking all factors into consideration the transplant ethics committee has decided not to approve the application.

³ In this form, “paired donation” refers to the donation by a living donor (Donor A) of any organ from his/her body in consideration of —

(a) a donation of an organ from another living donor for the purpose of the transplantation of the organ to the body of a living recipient of Donor A’s choice (Recipient A); or

(b) priority in the selection of Recipient A as a recipient of any organ, whether removed pursuant to section 4 of the Act or otherwise.

Name: ____________________________	Signature: ______________
Medical practitioner employed or otherwise connected with the hospital
Name: ____________________________	Signature: ______________
Independent medical practitioner
Name: ____________________________	Signature: ______________
Layperson
Date of authorisation: _________________
Note: If the living donor organ transplant is not carried out within the validity period, a fresh application for written authorisation must be made to the transplant ethics committee.
*Delete whichever is inapplicable.

COMPARATIVE TABLE

Human Organ Transplant Regulations 2004

This subsidiary legislation has undergone renumbering in the 2025 Revised Edition. This Comparative Table is provided to help readers locate the corresponding provisions in the previous version.

2025 Ed.	S 213/2004
4—(2)	4—(1A)
(3)	(2)
(4)	(3)
(5)	(3A)
(6)	(4)
(7)	(5)
(8)	(6)
[Omitted as having had effect]	9