What is the ruling on organ transplantation?

Al-Hawini: I heard a fatwa from our Shaykh regarding the impermissibility of organ transplantation?

The Shaykh: Yes, this is a matter for another discussion; because organ transplantation involves likening Allah to creation, either by the living volunteer, or by the deceased from whom his organ is taken by force. For this reason, it is not permissible.
Al-Hawini: Ah, well, I wanted our Shaykh to shed light on this issue; because blood was the path to the issue, and is there a difference between them? And what is the difference between the permissibility of blood transfusion and the impermissibility of organ transplantation? Even though both are transfers?

The Shaykh: Correct, both are transfers and both are sales, and some of it is permissible and some of it is usury or interest. So the fact that usury or interest shares in the sale does not give us the ruling of the permissible sale. So this is a transfer and this is a transfer, and a man travels by a prescribed path, and another travels by a path that is not prescribed. So the sharing in a part like this sharing in transfer does not harm; because the operative cause, as I mentioned to you just now, is likening Allah to creation. I said that transferring an organ from a living person who donates it is likening Allah to creation with him, and transferring it from the deceased is taking it from him by force, which is not permissible. So there is a great difference between this and that.
Al-Hawini: Yes, but likening Allah to creation, my Shaykh, means for example if one person transplants a kidney, where is the one who is likened to Allah? I mean the one who is likened to Allah might be...

The Shaykh: Every question has an answer. When you said organ transplantation, I turned the topic to what involves likening Allah to creation, whereas you are limiting the question and defining it by the transplantation of a kidney, for example. We say that in another way, Allah the Mighty and Majestic did not create two kidneys for a person in vain, but for a profound wisdom, and doctors know that better than anyone else. So if a man volunteers one of his kidneys, it is possible that he exposes his life to destruction; because the other kidney may be exposed to malfunction, so the first kidney that he donated serves as a substitute for it. Therefore, it is not permissible, just as it is not permissible at all if we suppose a person has two hands, and he donates one of his hands, even for a high price. This undoubtedly falls first here into likening Allah to creation, and secondly into changing the creation of Allah. And this operative cause includes donating one of the two kidneys. And we know from our discussion with many of our believing brother doctors, when we asked them: Are you aware of the future of the remaining kidney? You have removed one after a detailed examination you perform on both kidneys, and you require that they be sound. So you have removed one of them. Are you assured that the other kidney cannot be exposed to corruption or to a deficiency in performing their function? This deficiency may expose its owner to some harm or destruction? They said: No, we judge by what is apparent now, so we say these two kidneys are sound. If their owner permits us to remove one of them, we do so. As for whether it is permissible that the remaining kidney may be exposed to some malfunction or corruption, this is a real matter that has no deterrent, or it is a matter that may occur and we cannot guarantee that it will not happen. And thus, the wisdom of Allah Blessed and Exalted is He in creating two kidneys is an apparent, profound wisdom. It is not permissible for this person, whom Allah has favored with both, to favor one of them at the expense of the other. This is what we hold Allah to. And the summary of the matter is that volunteering an organ, either it is apparent, in which case there are two operative causes: likening Allah to creation and changing the creation of Allah. Or it is internal, like the kidney, in which case there is the single operative cause, which is changing the creation of Allah the Mighty and Majestic from one aspect, and added to that is that he may expose himself to destruction, or at least to harm from another aspect.