Transplant scandal fatty liver transplanted

Federal Medical Association test report shows the extent of the transplant scandal

24/03/2014

The accused surgeon in the process of the Göttingen transplant scandal had repeatedly stated that he had wanted only the best for his patients. But the now published test report of the German Medical Association comes to completely different conclusions.

Policy violations in three quarters of cases
The accused surgeon in the process of the transplant scandal at the University Hospital Göttingen had repeatedly pointed out that he had always wanted and done the best for his patients. As „NDR 1“ reported last summer, the defendant said he was „Ready for the patients day and night“ and have his profession as a doctor „a life task“ considered. But a recently published report by the German Medical Association (BÄK) is difficult to reconcile with this self-presentation. A total of 105 cases from the time when the defendant was head of the Göttingen transplantation surgery, examined the board of examiners of the medical association. The examiners found guideline violations in 79 patients. This is more than three quarters of cases.

Not always for the benefit of the patients
As the report shows, the violations were by no means always for the benefit of the patients, but on the contrary. For example, a number of patients who, in the opinion of the examiners, should not have had any donor liver, experienced a dramatic decline in their health after the transplant. The medical association had all 24 liver transplant programs examined at German hospitals and presented the results in September 2013. However, with the exception of the report on the University of Göttingen, which has just been published. The doctor is accused of attempted manslaughter in eleven cases and intentional bodily injury resulting in death in three cases. However, the test report lists significantly more cases than are being negotiated in the process. The surgeon is accused of presenting patients sicker by reporting manipulated medical data than they actually were, so they could be given a donor liver more quickly. In addition, he is said to have transplanted three patients to a liver, although they needed no.

Patients were not in the hospital for alleged blood sampling
The extent and the system of manipulation are made clear by the report. The auditors base their suspicions on several indicators. For example, there were large unexplained leaps in the laboratory for patients who could not be reconciled with the other disease. Despite the values ​​indicating a significant deterioration in health, doctors did not do anything. Some patients were at home, even though they were so ill on paper that they needed hospitalization. The Commission believes that the medical profession knew that the values ​​did not reflect actual health. In addition, the values ​​just before the transplantation suddenly returned to their previous level. Another peculiarity that was found was that several patients whose supposed values ​​were reported to Eurotransplant were not in the hospital on the day of the alleged blood sample. In addition, it is suspected that two patients who were transplanted the same day, the same third-party blood of a third patient was pushed.

Medical qualities questioned
In those cases where laboratory staff pointed to the unusual values, they were told that the blood samples had been confused. Whereupon the documents were corrected, but only internally. A report to Eurotransplant did not take place and so the patients were listed there with the high values. In addition, the auditors found numerous misstatements about dialysis. For example, in many cases alcohol bargaining times were not checked. The report also raises questions about the medical qualities. Accordingly, there were apparently significant shortcomings in the medical history, such as that findings were not collected and symptoms were not clarified or that in a patient a nine-inch-large carcinoma was overlooked. As the report states, this is „barely comprehensible“. In part, the alleged quality defects had dramatic consequences. Thus one would have in the opinion of the examiner in one case the „absolutely inadequate“ Need to improve medication. Instead, the patient had unnecessarily received a new liver. He then had to be transplanted again and died later.

Patient receives fatty liver
In another case, the patient had become very seriously ill only through the transplantation. He was transplanted a liver that was 90 percent fat. The patient's own liver had been better than the fatty liver he had received. In addition, the investigators considered that a patient who had even been transplanted three times and died from a multiple organ failure should never have been reported, as she had a clear contraindication. In the face of her ordeal would become „the question of the meaning of medical behavior“ force.

Donor numbers plummeted drastically due to scandal
But not only the patients were victims of the transplant scandal, but also those people who are still waiting for a donor organ. Because of the scandal, donor numbers in Germany had plummeted dramatically. Trust in transplantation medicine has been shaken altogether. According to figures from the German Foundation for Organ Transplantation (DSO), last year only 876 dead people donated organs. Compared to the last 23 years, this represents a new national negative record. For the approximately 11,000 patients who are currently waiting for a donor organ, the situation is precarious, because every day three people die while waiting for a donor organ. (Sb)

Image: Henrik G. Vogel