Concerns over source of livers for transplant

Grisly news out of China, where a medical journal assessing the outcomes of liver transplants has been forced to retract a paper on concerns that organs came from executed prisoners.

The study was published last year in the prestigious journal Liver International. It looked at 564 liver transplantations performed at Zhejiang University’s First Affiliated hospital between April 2010 and October 2014.

The authors of the study wrote that “all organs were procured from donors after cardiac death and no allografts [organs and tissue] obtained from executed prisoners were used”.

But doubts have been raised about that.

Wendy Rogers, a professor of clinical ethics at Macquarie University in Sydney, says that it was impossible for one hospital to have obtained so many useable livers from cardiac deaths alone.

“International programs report relatively low rates of procurement of livers from DCD donors,” Rogers wrote in a letter to Liver International’s editor, quoted in The Guardian newspaper. “In the USA, rates of liver transplant from DCD donors in the years 2012-14 were 32%, 28% and 27% respectively. If retrieval rates are similar in China, this would require 1,880 DCD donors, assuming a retrieval rate of 30%, to transplant the 564 livers reported in this paper.

“Given that there were only 2,326 reported voluntary donations in the whole of China during 2011–2014, it is implausible that this small pool could have resulted in 564 livers successfully retrieved … unless the surgeons there had exclusive access to at least 80% of all voluntary donors across the whole of China in this period.”

The journal’s editor, Mario Mondelli told The Guardian he will issue a formal retraction notice and a full transcript of his interactions with the surgeons in the journal’s next edition, along with the letter from Rogers.

“The authors’ institution was given until last Friday 3 February to provide evidence against allegations supported by data that organ procurement for liver transplantation was not from executed prisoners,” he told the paper. “However, there was no answer.”