Organ transplantation from living related donors in Bangladesh first began in October 1982, and became commonplace in 1988. Cornea transplantation from posthumous donors began in 1984 and living related liver and bone marrow donor transplantation began in 2010 and 2014 respectively. The Human Organ Transplantation Act officially came into effect in Bangladesh on 13th April 1999, allowing organ donation from both brain-dead and related living donors for transplantation. Before the legislation, religious leaders issued fatwa, or religious rulings, in favor of organ transplantation. The Act was amended by the Parliament on 8th January, 2018 with the changes coming into effect shortly afterwards on 28th January. However, aside from a few posthumous corneal donations, transplantation of vital organs, such as the kidney, liver, heart, pancreas, and other body parts or organs from deceased donors, has remained absent in Bangladesh. The major question addressed in this article is why the transplantation of vital organs from deceased donors is absent in Bangladesh. In addition to the collection of secondary documents, interviews were conducted with senior transplant physicians, patients and their relatives, and the public, to learn about posthumous organ donation for transplantation. Interviews were also conducted with a medical student and two grief counselors to understand the process of counseling the families and obtaining consent to obtain posthumous cornea donations from brain-dead patients. An interview was conducted with a professional anatomist to understand the processes behind body donation for the purposes of medical study and research. Their narrative reveals that transplant physicians may be reticent to declare brain death as the stipulations of the 1999 act were unclear and vague. This study finds that Bangladeshis have strong family ties and experience anxiety around permitting separating body parts of dead relatives for organ donation for transplantation, or donating the dead body for medical study and research purposes. Posthumous organ donation for transplantation is commonly viewed as a wrong deed from a religious point of view. Religious scholars who have been consulted by the government have approved posthumous organ donation for transplantation on the grounds of necessity to save lives even though violating the human body is generally forbidden in Islam. An assessment of the dynamics of biomedicine, religion and culture leads to the conclusion that barriers to posthumous organ donation for transplantation that are perceived to be religious may actually stem from cultural attitudes. The interplay of faith, belief, religion, social norms, rituals and wider cultural attitudes with biomedicine and posthumous organ donation and transplantation is very complex. Although overcoming the barriers to organ donation for transplantation is challenging, initiation of transplantation of vital organs from deceased donors is necessary within Bangladesh. This will ensure improved healthcare outcomes, prevent poor people from being coerced into selling their organs to rich recipients, and protect the solidarity and progeny of Bangladeshi families.

孟加拉国活体供体器官移植始于 1982 年 10 月，1988 年开始普及。死后供体角膜移植始于 1984 年，活体供体肝脏和骨髓供体移植分别于 2010 年和 2014 年开始。《人体器官移植法》于 1999 年 4 月 13 日在孟加拉国正式生效，允许脑死亡和相关活体捐赠者的器官捐赠用于移植。在立法之前，宗教领袖发布了法特瓦，或宗教裁决，有利于器官移植。议会于 2018 年 1 月 8 日对该法案进行了修订，之后不久将在 1 月 28 日生效。然而，除了少数死后角膜捐赠外，在孟加拉国仍然没有移植重要器官，例如肾脏、肝脏、心脏、胰腺以及已故捐赠者的其他身体部位或器官。本文讨论的主要问题是，为什么孟加拉国没有从已故捐赠者身上移植重要器官。除了收集二手资料外，还采访了资深移植医师、患者及其亲属和公众，了解器官移植的遗体捐献情况。还与一名医学生和两名悲伤辅导员进行了访谈，以了解向家属提供咨询并获得同意从脑死亡患者那里获得死后角膜捐赠的过程。与专业解剖学家进行了访谈，以了解出于医学研究和研究目的而捐献身体的过程。他们的叙述表明，移植医生可能不愿宣布脑死亡，因为 1999 年法案的规定不明确且含糊不清。这项研究发现，孟加拉人有很强的家庭关系，并且对于允许分离死去亲属的身体部位进行器官捐赠进行移植或捐赠尸体用于医学研究和研究目的感到焦虑。从宗教的角度来看，为移植而进行的死后器官捐赠通常被视为一种错误的行为。经政府咨询的宗教学者以挽救生命的必要为由批准了死后捐献器官进行移植，尽管在伊斯兰教中普遍禁止侵犯人体。对生物医学、宗教和文化动态的评估得出的结论是，被认为是宗教性的为移植而进行的死后器官捐赠的障碍实际上可能源于文化态度。信仰、信仰、宗教、社会规范、仪式和更广泛的文化态度与生物医学和死后器官捐赠和移植的相互作用非常复杂。尽管克服器官捐赠移植的障碍具有挑战性，孟加拉国有必要开始从已故捐赠者身上移植重要器官。这将确保改善医疗保健结果，防止穷人被迫将他们的器官卖给富有的接受者，并保护孟加拉国家庭的团结和后代。