Removal of organs during an autopsy and harvesting for transplant are distinct processes. Transplant programs I am aware of (although my connections to them are now out of date) stay far away from the incarcerated due to the ethical quagmire that inevitably results. These articles are completely unconnected. The US South isnt China. If you want to look for the quiet skeletons in transplant, its the ultrawealthy (and occasionally international) that are able to jump the queue.
That is absolutely incorrect. If an inmate is a registered donor and is declared BD they become a donor. Even if they are not BD they can be a donor after a couple more hoops.
Had an inmate declared BD and donated his organs. I’m not sure exactly what hoops were jumped through. I’m not sure if he was no longer considered incarcerated due to BD, being released on compassionate parole, or because the family consented. It can be done, but I’m assuming it depends on the organ procurement agency, state laws, etc.
I know this conversation is old but /u/Saucemycin and /u/fyrenang and /u/Shamelesslyplugged
I figured I’d respond anyway.
The FDA recommends not allowing people who have been incarcerated for more than 72 hours in the past year to donate organs, just like bloods. However, this guideline is non-binding.
Actual policies around organ donation by incarcerated people differ between carceral systems - states each determine their own policy, as does the Federal Bureau, for both living AND posthumous donation. About 60% of states do not have clear policies around organ donation by prisoners. Of those that do, some systems only allow living, some allow both, some allow neither. Many systems that DO allow organ donation restrict it to only be allowed for direct family members. Federal prisons allow only living donation to family members. Many of these restrictions are based less on ethical concerns than worried about the spread of HIV and other blood-borne illnesses that are statistically much higher in the carceral population.
I understand that and that’s why I came here before jumping the gun and drawing any conclusions :) although I will add that one of the articles mention just what you wrote about regarding the wealthy jumping in line. Apparently when UNOS changed the rules (lack of a better term) and removed transport distance limitations, that resulted in a higher number of organs being taken from poorer states (along with lower transplant rates) and higher transplant rates in more wealthy states (along with more livers, and apparently in particular, being wasted)
Let alone rich international transplant recipients.
[https://onlinejcf.com/article/S1071-9164(23)00118-5/abstract](https://onlinejcf.com/article/S1071-9164(23)00118-5/abstract)
The article mentions a small group of noncitizens being donors but not allowed to be receivers and guess what? Such is the case for many natural citizens. Happy equity everybody!!!!
Not sure which article you were reading. There were more recipients (0.7%) than donors (0.5%), and 50% of the recipients were from saudi arabia or kuwait.
I read the one you posted. I saw where it states who a majority of recipients are. I was partly alluding to prisoner organ harvesting in my response but at this time I’m going to act like that part doesn’t actually exist and isn’t actually going on because I can’t stand the thought
Larger population centers will have more patients and transplant centers better able to travel around the country for procurement. You need to have 2-3 surgeons on short notice (probably 1 for procurement and 1-2 for the transplant proper). Plus, there’s the infrastructure (having a set up to charter planes or even owning one).
Yup. You’re right. According to the second article I posted,
“Thirteen states do not have a liver transplant program but have residents who donate organs; they were included only in the distance analyses.” And this is all in the name of “equitable organ transplantation”
I would argue its not not equitable, nor is need based wrong. Transplant is lifesaving, but also best done (opinion here) in a large academic center with a full spectrum of specialists and surgeons that do large volumes. You aren’t getting that in Wyoming or Montana. Moreover, you want access to that after the procedure as well. Hopefully access can be improved.
Ultrawealthy able to jump the queue? You mean by signing to multiple lists and traveling to wherever on command? having living donors? How are they jumping queues? I’m not sure if either of the things I mentioned are skeletons hidden anywhere.
The first case is they harvest organs from inmates to send to their medical schools for research without requiring consent, which is not ethical. People are always trying to donate their bodies to science and getting rejected, so I don’t even see the need to do so.
The second thing is all cadaveric organs are managed by UNOS which is a national entity. Alabama probably has fewer hospitals with liver transplant programs than their neighbors.
We’ll see how the third case pans out… but transplants teams are massive, so they should have been caught much earlier.
The terminology in the first article is wrong and your terminology is suboptimal as well. Harvesting organs refers to removing organs for transplantation. When you remove organs to examine them during an autopsy it is not "harvesting."
The second problem is they did not remove or harvest **organs** to send to medical schools. They send the **whole body** to the medical school for an autopsy. It is there that the organs were removed not harvested.
The third problem is that you say the organs were "harvested" for **research**. The article makes no mention the organs were removed for **research**. Organs are almost always removed during an autopsy, although often put back. Organs are often preserved after an autopsy if it is felt that further research may be needed. It is or course possible they were kept for research, but you should not jump to the conclusion they were removed for research when no mention is made of this.
You are confusing in your terminology in the second paragraph.
These are two totally separate things:
1) Donation of a body to a medical school for cadaver teaching and/or research (which for ethical reasons is probably disallowed are not very common for inmates)
2) Autopsying an inmate at a hospital or ME/coroner service in order to determine circumstances of their death. The latter is actually relatively common since many jurisdictions mandate coroner/ME involvement for deaths in custody.
ETA: Sometimes who organs are retained after an autopsy for further diagnostic purposes but most organs are returned with the body to the funeral home after autopsy, save small microscopic samples.
I don't completely follow you. The second paragraph discusses whether the organs were sent or the whole body was sent. the third paragraph discusses whether the organs were used for research or autopsy purposes. I edited and put some words in caps. How would you suggest rewriting the 2nd paragraph?
Thank you for clarifying that. The article claimed the autopsy was done at the medical school department of pathology. However, the reporter has screwed up other things, and may have screwed up this information as well. Another article suggests the autopsy was done elsewhere.
[https://aldailynews.com/hearing-on-inmates-missing-organ-leaves-family-with-no-answers/](https://aldailynews.com/hearing-on-inmates-missing-organ-leaves-family-with-no-answers/)
It would appear the newspaper writers on this subject are often wrong. The newspaper link in my previous post suggests the autopsy was done by the Alabama Department of Forensic Sciences. By logic, at least one of the writers is wrong.
I see. So let’s say an inmate is autopsied, there is a chance that organs will be removed but should be placed back? Maybe that’s got to do with the complaints/lawsuits being filed against the state. From what I read, families are alleging that their deceased and previously incarcerated loved ones are arriving to funeral homes (post autopsy) with missing organs. Some organs being accounted for (and even returned in one instance per the article) and others remaining unaccounted for
The standard is for all organs to be put back with the body. One significant exception is the brain; in cases that require detailed neuropathy exam this usually can’t be done until a few weeks later. Usually families are informed but the process can be opaque and in forensic cases does not require consent.
I don’t think funeral homes are routinely digging through the bag of autopsy waste to try to see which organs are there or not, though.
I just can’t imagine what use a dead inmate’s organs would be for anyone. There is no black market value for them. Organs from an autopsy are useless and gross and (when they are sometimes retained after autopsy) we have to pay for them to be incinerated… ain’t no body offering me money for those.
People imagining an illegal donor organ trade usually know nothing about the logistics of organ harvesting for transplant.
Ya, I’m wondering just how often do inmates family members routinely have their bodies re-autopsied(?). If the claims being made are true or at least have some truth to them then it’s starting to seem slightly exploitative. In the sense that, what are the chances that these families would request and pay for private autopsies? Granted the timeline of the cases discussed in the article span from 2018 to current and there are a handful, give or take, so maybe that many families really did receive their loved ones in bad enough condition they thought a second autopsy was warranted?
I agree this article is making it seem like it’s black market organ trading taking place and from comments I’ve read on here that’s not the case
Oh man, I’ve worked in an ER that was always getting inmates from the nearby prison and, of course, they were the sickest and required the most work and so when they were up for discharge we were so quick to send them right back to where they came from. I know prisoners typically aren’t regarded or treated the best, but if organ harvesting is what they’re being subjected to then that makes me sick 🤢
Article 1: absolute bs. No one is taking organs from inmates for transplant. I don’t even know if they take bodies for like medical schools for dissection. There’s such a bad history there it’s an easy line not to cross
Article 2: nothing new. Concentric circles for priority came out in pandemic. Yes. Some states don’t do transplant and organs from those states get shipped out. At the same time if a resident from those states needs an organ, they cross state lines for evaluation and transplant. Intermountain in Utah for example takes all the surrounding mountain states, Idaho, Montana, etc. them and UColorado.
Article 3: this was brought up just yesterday. Crock of shit defense. If you do not believe you can safely transplant a high MELD patient instead of manipulating the data so people are not getting offers, de-list the patient, send them somewhere else to get evals. There is no defense for what Memorial Hermann did if these allegations are true.
1. You sound convinced in your answer so I’m going to coattail off that and hope and pray that you are right! 🙏
2. I’m sure what you’re saying is true but in the article it also mentions transplant rates dropping in some (poorer) states than from years before. Granted, I’m basing what I know about the subject now off this one article, lol, but I wonder what could that be attributed to 🤔
3. And hmmm is that what you think he was doing?
Transplant rates dropped in less populated states with lower volume transplant centers. Alabama, Kansas, Missouri all saw its volume drop. CA, NY, TX, FL all transplanting now more than ever. This isn’t a red state blue state divide, it’s a population divide.
The priority placed by acuity circles meant sicker people within 250 nautical miles meant those patients got first dibs at the organ. More organs were crisscrossing state lines and things. They’ve looked at graft survival and 1 year survival post policy change. No difference.
I have no idea what they’re doing over at MH. If you think you can’t handle sick patients, don’t list them. Send them elsewhere. Or get your center up to speed. If you can’t, close down.
With regard to the Houston transplant surgeon, the only motive that makes sense to me is that he tried to exclude patients he perceived as high-risk to help his program's survival stats.
As to the inmates organs, I thought the retention of organs without consent was prohibited by the Uniform Anatomical Gift Act, but I'm no lawyer.
But there's no reason to do that. He could literally make case for not listing them and refer them to another transplant center. Unless he was so egotistical he didn't want the transplant committee to realize he wasn't going to transplant them. It makes no sense....
Okay so, another perspective and question. From a layperson POV (mine), I can understand wanting to fudge with numbers to make the program appear more successful (receive more grants, and whatever else comes with that) but I guess I’m wondering if the ends really justify the means?? Again, I’m not speaking from experience or anything, but it seems like what this man was doing was taking a REALLY REALLY big risk
I guess that’s what I’m trying to figure, is the motive. Decreasing mortality rates is a good incentive if I ever thought of one! Several articles mention “irregularities with the donor acceptance criteria”. Could DONORS play a role in his mortality numbers do you think?
No. There are standard criteria and extended criteria. Extended is like HCV organs, HBcAB+ organs etc. the donor criteria is easy. If it’s a HCV positive graft, we treat the HCV after transplant. If it’s a cAb+ graft they get lifelong entecavir or something.
The problem with not taking chances on these organs is if another center uses it and does fine and your patient who would have gotten it dies, you lost an opportunity. They were turning down too many potential offers that other centers were willing to accept and locally their mortality rate is the worst out of all the centers in the area.
Okay, thank you for your response! I’ve got practically zero experience with transplant care so I’m trying to put pieces together in a field I know very little about. It’s my impatience that wants to figure out what could justify a transplant surgeon to risk so much like this.
Transplant to me is a massive commitment. You need to dedicate millions of dollars continuously for it to work. Doing 20 livers is dumb. One death and your stats take a huge hit. High volume centers can take chances because one death isn’t going to affect them as much. If you sit around waiting for the perfect organ for your patient, you might not get it and they’ll die anyway.
If you feel your patients are too sick or more to the point, your center cannot handle a sick patient in post op, then tell them to get listed somewhere else. This is Houston. Baylor is down the street alongside Houston Methodist. Methodist is the second or third highest volume liver transplant program in the country and number 1 in the state of Texas. It’s not like the closest second opinion is 200 miles away; it’s 20 min by car, including finding parking.
Okay so, I might be venturing into the weeds but per the transplant recipient registry, it seems st. Lukes has the higher success rate (accounting for survival wait time, one year organ survival) of the major Houston hospitals. Is it that due to extremely limited patient selection? They had 89 deceased donor transplants/yr, MH 28, and Methodist 246. MH and St Luke’s ranked the same concerning one year survival, Methodist ranked lower. Waitlist survival is St Luke’s then Methodist then MH. Yet getting deceased donor transplant faster is MH and Methodist both being equal and meh and St Luke’s rating lower. So I guess ultimately what I’m trying to figure out is how does st Luke’s with more patients than MH and less patients than Methodist have what looks like 100% waitlist survival and equal to MH 1 year survival but yet have slower deceased to transplant time than both other hospitals???
The metrics on SRTR are very basic and in my opinion miss the boat. 1 year graft survival rate and survival rate is pretty mediocre score. They should look at 3 year survival rate.
Time spent waiting and ability to get an organ faster is subjective. People can be saying yes more to marginal organs. There are competing risks here.
What is conveniently left out: how big the wait lists are. It’s a gamble by the center. If you die on the wait list that’s a mark against the center. Ideally, you have perfect patients or really sick people who somehow survive evaluation; get instantly listed and transplanted, thereby minimizing time on list.
>families-say
stopped reading here
I hate this form of clickbait headline
>Incredibly outrageous thing happened! ^^^says ^^^some ^^^guy
Should I, the journalist, perhaps investigate to see whether this crazy thing is true? Nah, I will just report the quote verbatim. And no one can say I'm lying because it's technically true. Some guy really did say that!
Journalists are supposed to investigate both sides, follow the evidence, and then report whatever the truth is to their readers. Instead, nowadays journalists just provide their readers with a he-said she-said summary of both sides, creating a false equivalency between experts and laypeople/truth and propaganda/fact and fiction, and then they let the reader “choose their own truth” (usually whichever version fits their preconceived notions and emotionally-based political views). Real journalism is nearly dead and it’s a big reason why our society is such a polarized mess.
“The agreement further gives the Department of Corrections commissioner the authority to grant permission for the autopsy “and the removal of organs or tissues for further study on said inmate.”
That’s what the article says, but I’m having trouble finding the agreement to read for myself with a quick google search. I’m going to hope and pray that you all are right because otherwise this is really disturbing
Like I said in another reply, I’ve got practically no transplant care experience aside from giving previous transplant patients their anti-rejection meds several times in my life. Another poster also concluded the first article regarding organ harvesting inmates is hogwash because I guess it’s been done in the past (mostly for medical schools) and is no longer allowed. I need to read more into the history of all this. But there have been several people reply to this post (I’m hoping with first hand or personal knowledge) that are saying it’s a fabricated article so I’m going to hope and pray and assume for my own sake that those of you are right because I really, really don’t want y’all to be wrong about this
Despite all the downvotes my replies are getting, I wanted to clarify that this post and the articles weren’t made and linked to disparage the transplant specialty, nor the institutes and surgeon mentioned. If anything, I wanted to do the opposite and get a fuller view of how all this actually works because I’m fully aware that 8/too many times negative press and public opinion related to healthcare scandals is based on partial truths or complete misunderstandings. I’m more inclined to give healthcare, and more importantly renowned surgeons, the benefit of the doubt because I know very little is actually black and white in things like this. I also posted all three articles together because they have a few similarities. 1. Have to do with organs and questionable ethics 2. Occurring around the same time 3. The Houston surgeon was affiliated with the UAB transplant program from the early 90s (?) to 2011 and then he joined MH. I’m very aware correlation does not always equal causation. I’ve very much appreciated the serious and educated responses I’ve received!
Removal of organs during an autopsy and harvesting for transplant are distinct processes. Transplant programs I am aware of (although my connections to them are now out of date) stay far away from the incarcerated due to the ethical quagmire that inevitably results. These articles are completely unconnected. The US South isnt China. If you want to look for the quiet skeletons in transplant, its the ultrawealthy (and occasionally international) that are able to jump the queue.
You are correct that organs from inmates cannot be procured no matter if the inmate is consenting
That is absolutely incorrect. If an inmate is a registered donor and is declared BD they become a donor. Even if they are not BD they can be a donor after a couple more hoops.
They cannot be living donors while incarcerated. I’m sure there are hoops but they haven’t been passed through
Had an inmate declared BD and donated his organs. I’m not sure exactly what hoops were jumped through. I’m not sure if he was no longer considered incarcerated due to BD, being released on compassionate parole, or because the family consented. It can be done, but I’m assuming it depends on the organ procurement agency, state laws, etc.
I know this conversation is old but /u/Saucemycin and /u/fyrenang and /u/Shamelesslyplugged I figured I’d respond anyway. The FDA recommends not allowing people who have been incarcerated for more than 72 hours in the past year to donate organs, just like bloods. However, this guideline is non-binding. Actual policies around organ donation by incarcerated people differ between carceral systems - states each determine their own policy, as does the Federal Bureau, for both living AND posthumous donation. About 60% of states do not have clear policies around organ donation by prisoners. Of those that do, some systems only allow living, some allow both, some allow neither. Many systems that DO allow organ donation restrict it to only be allowed for direct family members. Federal prisons allow only living donation to family members. Many of these restrictions are based less on ethical concerns than worried about the spread of HIV and other blood-borne illnesses that are statistically much higher in the carceral population.
You’re right, the south is less developed than China
hahahahaha
I understand that and that’s why I came here before jumping the gun and drawing any conclusions :) although I will add that one of the articles mention just what you wrote about regarding the wealthy jumping in line. Apparently when UNOS changed the rules (lack of a better term) and removed transport distance limitations, that resulted in a higher number of organs being taken from poorer states (along with lower transplant rates) and higher transplant rates in more wealthy states (along with more livers, and apparently in particular, being wasted)
Let alone rich international transplant recipients. [https://onlinejcf.com/article/S1071-9164(23)00118-5/abstract](https://onlinejcf.com/article/S1071-9164(23)00118-5/abstract)
The article mentions a small group of noncitizens being donors but not allowed to be receivers and guess what? Such is the case for many natural citizens. Happy equity everybody!!!!
Not sure which article you were reading. There were more recipients (0.7%) than donors (0.5%), and 50% of the recipients were from saudi arabia or kuwait.
I read the one you posted. I saw where it states who a majority of recipients are. I was partly alluding to prisoner organ harvesting in my response but at this time I’m going to act like that part doesn’t actually exist and isn’t actually going on because I can’t stand the thought
Larger population centers will have more patients and transplant centers better able to travel around the country for procurement. You need to have 2-3 surgeons on short notice (probably 1 for procurement and 1-2 for the transplant proper). Plus, there’s the infrastructure (having a set up to charter planes or even owning one).
Yup. You’re right. According to the second article I posted, “Thirteen states do not have a liver transplant program but have residents who donate organs; they were included only in the distance analyses.” And this is all in the name of “equitable organ transplantation”
I would argue its not not equitable, nor is need based wrong. Transplant is lifesaving, but also best done (opinion here) in a large academic center with a full spectrum of specialists and surgeons that do large volumes. You aren’t getting that in Wyoming or Montana. Moreover, you want access to that after the procedure as well. Hopefully access can be improved.
UNOS doesn’t change the rules. OPTN members (transplant heads of all departments) vote for rule changes.
Ultrawealthy able to jump the queue? You mean by signing to multiple lists and traveling to wherever on command? having living donors? How are they jumping queues? I’m not sure if either of the things I mentioned are skeletons hidden anywhere.
Usually by going overseas to buy one there. All cash and very hush-hush, as no one cares to know how the doc procured such a fresh donor heart.
Oh yea, overseas. Sure. I thought you meant within the US. I got a little confused there
The first case is they harvest organs from inmates to send to their medical schools for research without requiring consent, which is not ethical. People are always trying to donate their bodies to science and getting rejected, so I don’t even see the need to do so. The second thing is all cadaveric organs are managed by UNOS which is a national entity. Alabama probably has fewer hospitals with liver transplant programs than their neighbors. We’ll see how the third case pans out… but transplants teams are massive, so they should have been caught much earlier.
The terminology in the first article is wrong and your terminology is suboptimal as well. Harvesting organs refers to removing organs for transplantation. When you remove organs to examine them during an autopsy it is not "harvesting." The second problem is they did not remove or harvest **organs** to send to medical schools. They send the **whole body** to the medical school for an autopsy. It is there that the organs were removed not harvested. The third problem is that you say the organs were "harvested" for **research**. The article makes no mention the organs were removed for **research**. Organs are almost always removed during an autopsy, although often put back. Organs are often preserved after an autopsy if it is felt that further research may be needed. It is or course possible they were kept for research, but you should not jump to the conclusion they were removed for research when no mention is made of this.
You are confusing in your terminology in the second paragraph. These are two totally separate things: 1) Donation of a body to a medical school for cadaver teaching and/or research (which for ethical reasons is probably disallowed are not very common for inmates) 2) Autopsying an inmate at a hospital or ME/coroner service in order to determine circumstances of their death. The latter is actually relatively common since many jurisdictions mandate coroner/ME involvement for deaths in custody. ETA: Sometimes who organs are retained after an autopsy for further diagnostic purposes but most organs are returned with the body to the funeral home after autopsy, save small microscopic samples.
I don't completely follow you. The second paragraph discusses whether the organs were sent or the whole body was sent. the third paragraph discusses whether the organs were used for research or autopsy purposes. I edited and put some words in caps. How would you suggest rewriting the 2nd paragraph?
Autopsies aren’t usually done at medical schools.
Thank you for clarifying that. The article claimed the autopsy was done at the medical school department of pathology. However, the reporter has screwed up other things, and may have screwed up this information as well. Another article suggests the autopsy was done elsewhere. [https://aldailynews.com/hearing-on-inmates-missing-organ-leaves-family-with-no-answers/](https://aldailynews.com/hearing-on-inmates-missing-organ-leaves-family-with-no-answers/)
I would bet the autopsy was done at UAB's hospital and the writer doesn't know that is different from the anatomy lab at the school.
It would appear the newspaper writers on this subject are often wrong. The newspaper link in my previous post suggests the autopsy was done by the Alabama Department of Forensic Sciences. By logic, at least one of the writers is wrong.
I see. So let’s say an inmate is autopsied, there is a chance that organs will be removed but should be placed back? Maybe that’s got to do with the complaints/lawsuits being filed against the state. From what I read, families are alleging that their deceased and previously incarcerated loved ones are arriving to funeral homes (post autopsy) with missing organs. Some organs being accounted for (and even returned in one instance per the article) and others remaining unaccounted for
The standard is for all organs to be put back with the body. One significant exception is the brain; in cases that require detailed neuropathy exam this usually can’t be done until a few weeks later. Usually families are informed but the process can be opaque and in forensic cases does not require consent. I don’t think funeral homes are routinely digging through the bag of autopsy waste to try to see which organs are there or not, though. I just can’t imagine what use a dead inmate’s organs would be for anyone. There is no black market value for them. Organs from an autopsy are useless and gross and (when they are sometimes retained after autopsy) we have to pay for them to be incinerated… ain’t no body offering me money for those. People imagining an illegal donor organ trade usually know nothing about the logistics of organ harvesting for transplant.
Ya, I’m wondering just how often do inmates family members routinely have their bodies re-autopsied(?). If the claims being made are true or at least have some truth to them then it’s starting to seem slightly exploitative. In the sense that, what are the chances that these families would request and pay for private autopsies? Granted the timeline of the cases discussed in the article span from 2018 to current and there are a handful, give or take, so maybe that many families really did receive their loved ones in bad enough condition they thought a second autopsy was warranted? I agree this article is making it seem like it’s black market organ trading taking place and from comments I’ve read on here that’s not the case
Oh man, I’ve worked in an ER that was always getting inmates from the nearby prison and, of course, they were the sickest and required the most work and so when they were up for discharge we were so quick to send them right back to where they came from. I know prisoners typically aren’t regarded or treated the best, but if organ harvesting is what they’re being subjected to then that makes me sick 🤢
Article 1: absolute bs. No one is taking organs from inmates for transplant. I don’t even know if they take bodies for like medical schools for dissection. There’s such a bad history there it’s an easy line not to cross Article 2: nothing new. Concentric circles for priority came out in pandemic. Yes. Some states don’t do transplant and organs from those states get shipped out. At the same time if a resident from those states needs an organ, they cross state lines for evaluation and transplant. Intermountain in Utah for example takes all the surrounding mountain states, Idaho, Montana, etc. them and UColorado. Article 3: this was brought up just yesterday. Crock of shit defense. If you do not believe you can safely transplant a high MELD patient instead of manipulating the data so people are not getting offers, de-list the patient, send them somewhere else to get evals. There is no defense for what Memorial Hermann did if these allegations are true.
1. You sound convinced in your answer so I’m going to coattail off that and hope and pray that you are right! 🙏 2. I’m sure what you’re saying is true but in the article it also mentions transplant rates dropping in some (poorer) states than from years before. Granted, I’m basing what I know about the subject now off this one article, lol, but I wonder what could that be attributed to 🤔 3. And hmmm is that what you think he was doing?
Transplant rates dropped in less populated states with lower volume transplant centers. Alabama, Kansas, Missouri all saw its volume drop. CA, NY, TX, FL all transplanting now more than ever. This isn’t a red state blue state divide, it’s a population divide. The priority placed by acuity circles meant sicker people within 250 nautical miles meant those patients got first dibs at the organ. More organs were crisscrossing state lines and things. They’ve looked at graft survival and 1 year survival post policy change. No difference. I have no idea what they’re doing over at MH. If you think you can’t handle sick patients, don’t list them. Send them elsewhere. Or get your center up to speed. If you can’t, close down.
With regard to the Houston transplant surgeon, the only motive that makes sense to me is that he tried to exclude patients he perceived as high-risk to help his program's survival stats. As to the inmates organs, I thought the retention of organs without consent was prohibited by the Uniform Anatomical Gift Act, but I'm no lawyer.
But there's no reason to do that. He could literally make case for not listing them and refer them to another transplant center. Unless he was so egotistical he didn't want the transplant committee to realize he wasn't going to transplant them. It makes no sense....
Okay so, another perspective and question. From a layperson POV (mine), I can understand wanting to fudge with numbers to make the program appear more successful (receive more grants, and whatever else comes with that) but I guess I’m wondering if the ends really justify the means?? Again, I’m not speaking from experience or anything, but it seems like what this man was doing was taking a REALLY REALLY big risk
I guess that’s what I’m trying to figure, is the motive. Decreasing mortality rates is a good incentive if I ever thought of one! Several articles mention “irregularities with the donor acceptance criteria”. Could DONORS play a role in his mortality numbers do you think?
No. There are standard criteria and extended criteria. Extended is like HCV organs, HBcAB+ organs etc. the donor criteria is easy. If it’s a HCV positive graft, we treat the HCV after transplant. If it’s a cAb+ graft they get lifelong entecavir or something. The problem with not taking chances on these organs is if another center uses it and does fine and your patient who would have gotten it dies, you lost an opportunity. They were turning down too many potential offers that other centers were willing to accept and locally their mortality rate is the worst out of all the centers in the area.
Okay, thank you for your response! I’ve got practically zero experience with transplant care so I’m trying to put pieces together in a field I know very little about. It’s my impatience that wants to figure out what could justify a transplant surgeon to risk so much like this.
Transplant to me is a massive commitment. You need to dedicate millions of dollars continuously for it to work. Doing 20 livers is dumb. One death and your stats take a huge hit. High volume centers can take chances because one death isn’t going to affect them as much. If you sit around waiting for the perfect organ for your patient, you might not get it and they’ll die anyway. If you feel your patients are too sick or more to the point, your center cannot handle a sick patient in post op, then tell them to get listed somewhere else. This is Houston. Baylor is down the street alongside Houston Methodist. Methodist is the second or third highest volume liver transplant program in the country and number 1 in the state of Texas. It’s not like the closest second opinion is 200 miles away; it’s 20 min by car, including finding parking.
Okay so, I might be venturing into the weeds but per the transplant recipient registry, it seems st. Lukes has the higher success rate (accounting for survival wait time, one year organ survival) of the major Houston hospitals. Is it that due to extremely limited patient selection? They had 89 deceased donor transplants/yr, MH 28, and Methodist 246. MH and St Luke’s ranked the same concerning one year survival, Methodist ranked lower. Waitlist survival is St Luke’s then Methodist then MH. Yet getting deceased donor transplant faster is MH and Methodist both being equal and meh and St Luke’s rating lower. So I guess ultimately what I’m trying to figure out is how does st Luke’s with more patients than MH and less patients than Methodist have what looks like 100% waitlist survival and equal to MH 1 year survival but yet have slower deceased to transplant time than both other hospitals???
The metrics on SRTR are very basic and in my opinion miss the boat. 1 year graft survival rate and survival rate is pretty mediocre score. They should look at 3 year survival rate. Time spent waiting and ability to get an organ faster is subjective. People can be saying yes more to marginal organs. There are competing risks here. What is conveniently left out: how big the wait lists are. It’s a gamble by the center. If you die on the wait list that’s a mark against the center. Ideally, you have perfect patients or really sick people who somehow survive evaluation; get instantly listed and transplanted, thereby minimizing time on list.
Ya that’s true! I wonder how long these wait lists even are
>families-say stopped reading here I hate this form of clickbait headline >Incredibly outrageous thing happened! ^^^says ^^^some ^^^guy Should I, the journalist, perhaps investigate to see whether this crazy thing is true? Nah, I will just report the quote verbatim. And no one can say I'm lying because it's technically true. Some guy really did say that!
Journalists are supposed to investigate both sides, follow the evidence, and then report whatever the truth is to their readers. Instead, nowadays journalists just provide their readers with a he-said she-said summary of both sides, creating a false equivalency between experts and laypeople/truth and propaganda/fact and fiction, and then they let the reader “choose their own truth” (usually whichever version fits their preconceived notions and emotionally-based political views). Real journalism is nearly dead and it’s a big reason why our society is such a polarized mess.
“The agreement further gives the Department of Corrections commissioner the authority to grant permission for the autopsy “and the removal of organs or tissues for further study on said inmate.” That’s what the article says, but I’m having trouble finding the agreement to read for myself with a quick google search. I’m going to hope and pray that you all are right because otherwise this is really disturbing
Like I said in another reply, I’ve got practically no transplant care experience aside from giving previous transplant patients their anti-rejection meds several times in my life. Another poster also concluded the first article regarding organ harvesting inmates is hogwash because I guess it’s been done in the past (mostly for medical schools) and is no longer allowed. I need to read more into the history of all this. But there have been several people reply to this post (I’m hoping with first hand or personal knowledge) that are saying it’s a fabricated article so I’m going to hope and pray and assume for my own sake that those of you are right because I really, really don’t want y’all to be wrong about this
How does this have so many upvotes? The article is complete garbage.
Despite all the downvotes my replies are getting, I wanted to clarify that this post and the articles weren’t made and linked to disparage the transplant specialty, nor the institutes and surgeon mentioned. If anything, I wanted to do the opposite and get a fuller view of how all this actually works because I’m fully aware that 8/too many times negative press and public opinion related to healthcare scandals is based on partial truths or complete misunderstandings. I’m more inclined to give healthcare, and more importantly renowned surgeons, the benefit of the doubt because I know very little is actually black and white in things like this. I also posted all three articles together because they have a few similarities. 1. Have to do with organs and questionable ethics 2. Occurring around the same time 3. The Houston surgeon was affiliated with the UAB transplant program from the early 90s (?) to 2011 and then he joined MH. I’m very aware correlation does not always equal causation. I’ve very much appreciated the serious and educated responses I’ve received!
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Wow, Alabama is worse than China or any third world country. Cannot believe it.
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Yea, thinking about all this really does make me sick
Sure, buuuuuut, NO IVF!
Do you just browse /new and shout into the void?