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CMS - Medicare Liver Donor Living Donor Protections OPTN

More on Living Liver Donor Paul Hawkes and Lahey

First is Dan Walter’s blog, entitled “Profiles in Medical Ethics”, with the post “The Death of Number 215” referring to Paul Hawkes as Lahey’s 215th live liver donor surgery. Dan is also the author of “Collateral Damage”, about his wife’s death by ablation at Johns Hopkins.

 

Secondly, Lahey’s surgical team, Pomfret and Pompeselli, are wife and husband. The former operates on the living donor and the latter performs the procedure on the recipient. While there isn’t anything illegal about the arrangement, the fact the recipient’s surgeon *could* exert undue influence on the recipient and/or the recipient’s family to A. find a living donor and B. use his wife as the surgeon certainly strikes me as icky.

 

Jenkins, the dude who blamed all of Lahey’s CMS violations on paperwork snafus*, worked with Pomfret and Pompeselli at Beth-Israel before all three came to Lahey to perform live liver donor surgeries.

 

According to OPTN data, Lahey performed 23 live liver donor transplants in 2010. CMS regulations require a minimum of 10 per year to maintain certification.  (PS. University of Colorado, where living liver donor Ryan Arnold died in 2010, only conducted 3 living liver donor transplants that year, for a 33.3% mortality rate.)

 

UNOS/OPTN doesn’t collect data on the type of liver donor procedure performed. Why this is important is because hindsight tells us that when the transplant industry shifted from the open nephrectomy to the laparoscopic procedure, many deaths and maimings occurred due to the learning curve for the surgeons. Unfortunately, the true number were lost due to incomplete data collection.

 

Just a reminder, living liver donation carries a near 40% risk of complications in the US. For any other elective procedure, this rate would be completely unacceptable. But because the healthy person is being used ‘save someone’s life’, apparently doing such harm is okay.

 

 *And just how is denying Paul access to an Independent Donor Advocate an administrative mistake??

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