May 02, 2007
THE kidney could hardly be considered a properly functioning one - it came from a patient who had tested positive for hepatitisB.
And yet, urologist Makoto Mannami had it transplanted into one of his patients.
The man who received the kidney at Uwajima Municipal Hospital in Uwajima, Ehime Prefecture, Japan, later became infected with the virus, reported Japan's Yomiuri Shimbun.
As a result, he died of liver failure and acute pancreatitis, the hospital's inspection committee announced on Sunday.
The committee had been investigating a series of questionable transplants conducted by Dr Mannami since the 1990s, reported The Japan Times.
According to a report released by the panel, the man was one of two recipients of the kidneys taken from a woman who had tested positive for hepatitis B in December 2000.
The male recipient died about five months after the transplant. The other recipient has not been infected with the virus so far and is still alive, the panel said.
The deceased man tested negative for the virus before the transplant but was found to be positive shortly before his death, it said.
HARSH WORDS
Committee chairman Katashi Fukao, strongly criticised the transplants.
Said Mr Fukao: 'It was highly likely that the recipient got infected (with the hepatitis B virus) through the transplant.
'The transplant was fundamentally reckless and cannot be regarded as treatment.'
The report also concluded that all 20 cases in which diseased kidneys were removed for transplant by Dr Mannami, and 25 cases in which diseased kidneys were transplanted, were inappropriate.
Said Mr Fukao: 'The patient was an innocent victim of a transplant of a kidney that rarely functioned from the beginning. It was a transplant that should never have been carried out.'
Dr Mannami, 66, now a senior urologist at the Uwajima Tokushukai Hospital, said he thought infection would not occur at the time of the transplant.
He also said the patient died of severe pancreatitis, and insisted that the liver damage had no direct link to his death.
The controversy has prompted Japan's health ministry to review its guidelines on transplants of kidneys from sick patients.
Currently, transplants of kidneys harvested from dead donors who had cancer or hepatitisB are banned in Japan. However, there are no written rules concerning transplants from living donors.
In Singapore, doctors routinely screen donors for illnesses like hepatitis B and C, sexually transmitted diseases and HIV.
The Ministry of Health also introduced a formalised checklist of screenings and tests to be done on all potential donors in late 2003.
It covers dengue testing as well as the cause of any brain damage and checks for a history of cancer or recent suggestive symptoms. Any cancer, except primary brain cancer, automatically rules out a transplant