The Health Ministry has strongly defended the functioning of Israel Transplant the national center which aims to encourage organ donation and supervises their allocation to patients who need transplants.
Commenting on media reports about the tragic death Monday of a 38-year-old man after his kidney was removed to donate to a 44-year-old man, Health Ministry Deputy Director-General Dr. Yitzhak Berlovich said on Thursday that Israel Transplant is not in charge of approving the contribution of kidneys by altruistic live donors.
Instead, a ministry committee headed by senior physicians consider the four monthly requests on average that are presented and do their best to ensure that an unauthorized transfer of payment for the organ is not occurring behind the scenes.
"The process is not 100 percent effective, and some organ sales inevitably slip through the system," said Berlovich, "but we would not agree to lie-detector tests that make donors feel like criminals. A ministry-sponsored bill that has passed its first reading in the Knesset will make organ sales illegal, and violators will be punished."
As-yet unproven suspicions that the donor was allegedly in financial difficulty and was to be paid for the organ aroused a debate over the functioning of Israel Transplant. The man died of severe hemorrhaging at the Rabin Medical Center-Beilinson Campus in Petah Tikva 13 hours after the organ was removed. The recipient is doing well.
On Thursday, a report in Ha'aretz stated that a petition of senior organ transplant surgeons, headed by Prof. Eitan Mor of Beilinson, accused Israel Transplant, whose chairman is Prof. Jonathan Halevy and whose director is nurse Tamar Ashkenazi, of "poor functioning."
Mor declined to comment on Thursday. But the ministry said the authors of the letter, sent to Health Minister Dan Naveh, did not complain about the transplant coordinating center's functioning or criticize Prof. Halevy's performance, contrary to the Ha'aretz report. "They did bemoan the fact that too few organs are donated," the ministry statement said, and the fact that many people die on the queue while waiting for an organ.
Some 1,000 Israelis are on the list for a kidney, heart, liver, lung, pancreas or other organs. Of those, around 600 seek a kidney, which can be donated by a live contributor who can manage with only one healthy kidney of his own.
Berlovich said the center's annual budget, about NIS 5 million, is inadequate and must be increased. He said he personally favors hiring a half-time, paid chairman to be in charge of the center, as suggested by Halevy, who is director-general of Jerusalem's Shaare Zedek Medical Center and more than five years ago volunteered to serve as an unpaid chairman. Halevy asked in the summer of 2004 to be relieved of the Israel Transplant position, saying it was too much of a burden, but the ministry did not find a replacement.
Berlovich said that "in absolutely no connection with the publicity of the death of the donor, the ministry has for some time been considering a paid replacement. Prof. Halevy and Ashkenazi have devoted their time round the clock to the center and we are very pleased." He added that he number of registered would-be donors was raised from 200,000 to 270,000, a significant sum considering the challenges of convincing each and every donor.
"If we had two million registered," Halevy said, there would be no organ shortage, including kidneys. The center spends $100,000 to $300,000 each year for a month-long publicity campaign to promote registration for organ donation.
"But there is something about Israelis that makes it difficult for them to do this. There is some religious, cultural or psychological barrier even though we issue a special donor card that allows removal of organs only if the person's clergyman approves it in advance."
Though public service announcements were not particularly effective at gaining additional organ donors, interviews with organ recipients on Meni Pe'er's TV show and appearances by patients in shopping malls were proven to work.
He added that if Rabbi Shalom Yosef Eliashiv, the leading haredi rabbinical arbiter, were to come out with an endorsement of organ donation, it could provide a major boost for potential donors in the religious Jewish community. Efforts to persuade him have so far failed.
While Halevy said that giving priority on the organ waiting list to people who themselves registered as potential organ donors could significantly increase registration, Berlovich called that tactic unreasonable as one could not deny an organ to seriously ill people who had not registered. But both rejected the system used in some other countries called "presumed consent," in which organs can automatically be removed from people who have suffered brain death if they did not register their refusal in their lifetimes.
"This would be horrendous, because it would lead to body-snatching by relatives in the hospitals," he said.
"The Knesset would never agree to presumed consent," Halevy added.
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