Spain’s medical professionals enjoy a prestigious reputation throughout the world, and the transplant services at the country’s leading hospitals are held in high esteem by surgeons in many other countries, but one aspect of the service which has not been put to the test is the screening of transplants in order to ensure that organs are not being bought and sold.
That is, until now.
The case has come to light of a 61-year old Mayor from Lebanon who was diagnosed with a hepatic complaint, and doctors in his own country spoke highly to him of the surgeons and facilities in Spain. So he travelled to Valencia, with plans to seek a partial liver transplant.
The only thing missing for the operation was a donor: Lebanese doctors had informed him that his son, who was willing to take on the risks involved in order to save his father’s life, was not compatible. So the entrepreneurial Lebanese national embarked on a plan to find one for himself, offering 40,000 euros to the candidate who could help him achieve his aim.
In the end, through family and friends living in the Comunitat Valenciana, and restricting his search to those who were in desperate need of extra money, he managed to recruit nine people, two of whom are known to be an Algerian woman and a Rumanian man. At an expense to the Mayor of 12,000 euros, these nine were then subjected to a selection process at a clinic in Valencia, where the Algerian’s candidacy fell through when she was found to be pregnant, but the Rumanian was eventually successful. Not long afterwards, donor and recipient travelled together to the Hospital Clínic de Barcelona, one of only three in Spain where the necessary surgery is performed.
At this point his well-conceived plan failed. The Spanish transplant system includes a three-stage screening process before any operation is carried out, the first of which is an interview to ensure that the donation is being made wholly voluntarily, and that no money is changing hands. The hospital inspector was unconvinced, no family connection could be proved, and the request for the transplant was turned down.
At this point there was no proof of any wrongdoing, but, unfortunately for the prospective patient, in the meantime the Algerian woman who had been rejected on account of her pregnancy had reported the incident to an NGO, ( voluntary charity organization) who in turn alerted the Policía Nacional. The two loose ends were soon tied together, and as a result the five people responsible for the plan – the transplant patient and four collaborators, including three members of his family – were arrested this January and February and face a total of up to twelve years in prison.
Ironically, in some ways the story has a happy ending for the Lebanese patient. Recognizing the seriousness of his illness, hospital staff in Barcelona suggested that his son should come to Barcelona for a second opinion, and in the end he was found to be compatible after all. He volunteered to donate, and last August the transplant was performed successfully.
Although nobody can be certain that the system is failsafe, the Spanish health authorities are pleased that this case seems to show that the three-stage screening system worked at the first step. The other two stages which were not needed on this occasion are a report by the hospital’s Ethics Committee and a sworn statement before a magistrate on the part of the donor that the donation is being made altruistically.
However, there are questions over the role of the clinic in Valencia were the Rumanian was selected from the nine candidates who presented themselves. Despite the fact that most of them were illegal immigrants and underwent fairly specific procedures such as CT scans and hepatic volumetric testing in a short space of time, it seems that no alarm bells were sounded. Apparently they were presented at the clinic as health tourists keen to avail themselves of the clinic’s facilities.
At the moment this is the only known case of an attempt to buy organs in Spain, but in its wake it is certain that hospitals will be approaching their screening duties with even more diligence in future. Rafael Matesanz, the head of the National Transplant Organization, believes that Spain’s legislation on this matter is among the tightest in the world, and that the country is well safeguarded against repeat cases of this nature.
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