The Health Ministry is very concerned that the rare death on Monday of a "healthy" 38-year-old man whose voluntary donated his kidney to a 44-year-old friend will seriously deter other "altruistic" Israelis from giving organs.
Ministry deputy director-general Dr. Yitzhak Berlovich told The Jerusalem Post that the ministry greatly regretted the death of the man, reportedly separated from his wife and the father of a two-year-old son. The autopsy report has not yet been made public.
The recipient is in stable condition at the Rabin Medical Center-Beilinson Campus in Petah Tikva, where the donor kidney was removed by laparoscopic ("keyhole") surgery and transplanted by a separate Beilinson team.
The ministry and the hospital reported that the man died due to "uncontrollable hemorrhaging" 13 hours after the kidney was removed. Beilinson voluntarily decided to suspend laparoscopic removal of kidneys from live donors, even though this less-invasive technique is used in 80 percent of all such procedures in the US and has been successful in more than two dozen live-donor kidney removals so far this year, said Prof. Eytan Mor, director of Beilinson's department of kidney and liver transplantation.
Mor said the kidney was to be removed from the donor three weeks ago after a ministry-appointed committee approved the "altruistic" donation. An independent institute's psychological assessment of the recipient and donor found that the two men "were friends" and the committee concluded that no money was passing hands for the donated organ.
The kidney was not removed then, said Mor, because suddenly his blood pressure fell.
Anesthesiology chief Prof. Leonid Eidelman said that he was treated "and he recovered. We did many tests and found the would-be donor was healthy. So we approved it for Monday. The anesthesiology went ahead without any problem, and he was doing well. But suddenly he suffered from massive delayed bleeding, a leak in the artery to which the kidney had been attached. His condition deteriorated so fast that despite efforts to stop the bleeding, he died.
Mor said the surgeon who removed the kidney has done more than 200 such laparoscopic procedures, two dozen of them since January. He added that such a leak could have resulted from movement of the plastic clip holding the vessel closed or from an increase in abdominal pressure or blood pressure that might move it. But such complications are extremely rare, he added, and he had never seen such a death, which according to world statistics occurs after one out of 3,000 removals of kidneys from a live donor. The autopsy is expected to clear up the unanswered questions, he said.
Berlovich declined to comment on claims in the media (YNet and Army Radio) that the deceased donor and the recipient were in fact not really close friends, but that a deal had allegedly been made for the recipient to pay the donor, who the media reports said had financial troubles.
Berlovich did say that two years ago, the High Court of Justice said it was satisfied by the ministry's live-donor approval procedures.
Mor said that he had watched the donor and recipient together several times and saw that they "spoke a lot, like friends. The recipient is in shock over the death of the donor; he cried and took it very hard."
Berlovich said that he wouldn't consider introducing a requirement for a lie detector test for any potential live-organ donors and recipients to weed out under-the-table payments presented as altruism, "as potential donors are not criminals. We do all we can to get to the truth, but it isn't 100%."
The ministry initiated a bill that would criminalize the sale of organs for transplant, but it has not yet passed the Knesset, Berlovich said, as there are lobbyists representing people who want to be able to buy organs. The purchase of donor organs is illegal all over the world, the ministry deputy director-general concluded.