Organ donation scandal No explanation wanted?

Examination report shows deficiencies in organ transplantation in the Klinikum rechts der Isar

04/17/2013

After the allegations of violations in liver transplants in Bavarian university hospitals, now the investigation report of the German Medical Association throws no good light on the educational efforts at the affected hospital right Isar in Munich. As the „Southgerman newspaper“ Reported in the report of the Examination and Supervision Commission (PÜK) of the German Medical Association 36 violations of liver transplants are shown, which bring especially the medical director of the hospital in distress.

Last year, the trust of the population was shattered by the organ donation scandal and the willingness to donate organs, which was in any case low in Germany, declined significantly. Comprehensive education was promised and an examination of all transplants at possibly involved clinics was initiated. The PÜK also controlled all liver transplants performed at the Klinikum rechts der Isar between 2008 and mid-2012, with alarming results.

Numerous violations of guidelines for organ transplantation
The investigation report identifies 36 violations of the guidelines for organ transplantation, including, for example, ten violations of alcohol medications for alcoholics who had not overcome their addiction for more than the required six months. Also, apparently, 13 liver cancer patients were implanted with a donor organ, although they were not entitled to it, reports the „SZ“ citing the investigation report of the PÜK. In addition, in some cases "not only were false notifications made to the appropriate organ donor agency (Eurotransplant) but blood samples were also adulterated and added by adding urine".

Deficiencies in the education?
Although clinicians had internally called attention to the blood clutter immediately after the events in January 2010, but „the management did not want to know much about it“, like that „SZ“ on the results of the current study report. The urgently needed education did not take place. Instead, the Medical Director announced in a February 2010 letter that no wrongdoing had occurred. Meanwhile, the director told the newspaper that he had „always taken the necessary steps according to the current state of knowledge.“

Incorrect information on diseases of patients
For the misconduct in the establishment of required liver transplants, such as the invention of dialysis or the Blutpankerei, in the investigation report authoritative made an already dismissed surgeon. This is currently also prosecutorial investigations run. The defendant rejects the allegations, but has not submitted to the hearing by the PÜK. The „Southgerman newspaper“ quoted from the report: The representation of the doctor is „neither plausible, nor does it live up to the events of that time.“ Opposite the „SZ“ the accused had explained that he had assumed a confusion of blood samples. This assessment was corroborated by the information provided by the responsible employee and the exonerating letter from the medical director, the surgeon explained. The PÜK investigation report, however, concludes that it was the defendant's job, „to clarify or clarify the circumstances.“

At least three inadmissible transplant performed
It remains unclear even after the current investigation report whether the head of the transplant center might have been aware of the violations. The report merely states that even through this „an actually offered closer enlightenment did not take place.“In at least three cases a transplant had been carried out, „which should not have taken place.“ In the current report, only the head of the II. Medical Clinic, which „tirelessly pointed to his suspected manipulation“ have. Strangely enough, however, this is the only one against which the clinic had already filed a disciplinary action, as he had not endeavored adequately for the clarification. A question that is not pursued in the current report, are the motivations of the doctors for the manipulation of transplants. Did they think they acted out medical needs, or did financial issues matter??

Appearance of the hospital on the right of the Isar affected
In any case, the reputation of the hospital on the right bank of the river Isar has clearly suffered as part of the donation scandal. Even in 2010, the hospital was awarded the Bavarian Organ Donation Award by the Bavarian Minister of Health for its outstanding work. Thus, the special commitment of the hospital in the donation of organs should be rewarded. „We need consistent support for organ donation in every hospital“, At that time the Bavarian health minister Dr. Markus Söder and added: „The staff of today's hospital make an excellent contribution to the care of seriously ill patients.“ However, the current investigation report of the German Medical Association suggests that the support of organ donation in the Klinikum rechts der Isar went far beyond the permissible level. It should also be remembered that in view of the already scarce donor organs, an illegal transplantation always means that elsewhere patients do not receive their much-needed donor organ or have to wait longer, which in the worst case can bring the death of those affected. (Fp)

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Organ donation scandal: call for more controls
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Image: Dieter Schütz