Organ donors pressured, paid to donate

The Yomiuri Shimbun

October 13, 2006

A Yomiuri Shimbun survey has found 48 cases in which medical institutions decided not to perform kidney transplants after hospitals learned that donors were unrelated to people seeking a new kidney or may have been pressured to donate.

The survey found there have been a number of donation requests made that, had they been allowed, might have been illegal, similar to the recent case in Ehime Prefecture, in which a patient and his common-law wife were alleged to have paid an acquaintance to donate her kidney.

According to ethical guidelines set out by the Japan Society for Transplantation, a live organ transplant from a donor who is not a family member of a patient is prohibited except in special cases. However, the nationwide survey of medical institutions that have undertaken kidney transplants found that many patients seek to receive organs donated by friends or acquaintances.

Nagano Red Cross Hospital saw a person who had been receiving dialysis treatment at another medical institution. The person said, "My friend wants to donate a kidney."

When a doctor asked more questions about the friend, the person appeared evasive. So the doctor then contacted the institution that had previously treated the person, and it was found that the person had a connection to a loan-shark group.

The hospital decided to refuse to perform the kidney transplant, fearing the organ to be donated might come from someone who was in debt to the group and in financial trouble.

At Saiseikai Yahata General Hospital in Kitakyushu, a company president asked to have a kidney transplant. The company chief said the new organ was to be donated by a colleague, adding, "My subordinate understands this." However, the doctor denied the request as it was clear the employee may have felt pressured to donate.

One donation that a hospital helped prevent involved a company president who was being treated at Kochi Health Science Center and who brought a female employee to the center to act as a donor. When a doctor asked, "Why didn't your wife come with you here?" the patient looked uncomfortable.

After the doctor informed him that the hospital would not conduct a kidney transplant unless the donor was a family member, the two left.

The doctor said, "I think he tried to have the kidney donated by his lover."

Even among relatives, there remains a possibility that would-be donors have been paid or put under pressure.

At Fukuoka University Hospital, a person seeking a transplant came in with a parent who seemed to be suffering from dementia. The doctor turned down the request for a transplant operation, as the donor's intention could not be confirmed.

When a patient and a donor who were siblings visited Niigata University Hospital, it was found that the patient was rich and the donor was in financial difficulty. During discussions about the transplant, the donor decided not to proceed with the donation.

The survey found that the prevention of illegal and unethical transplants depended largely on hospitals.

Many hospitals claim the Ehime incident could not have been foreseen or that it would be impossible to prevent such donations from occurring when a patient and a donor conspire. Yet many medical institutions take their own preventive measures, such as having thorough discussions with patients and donors before performing operations.

Copyright © 2006 The Yomiuri Shimbun.

This article posted November 19, 2006.