One in four hearts skip the waiting list
New figures have revealed another opportunity for corruption in Germany's organ transplant system - not only can doctors pretend patients are sicker than they are to bump them up the queue - data on organs can also be manipulated.
The new Health Ministry statistics, obtained by Green Party health spokesman Harald Terpe and published by the Frankfurter Rundschau newspaper on Tuesday, show that the number of organs bumped up the system have increased dramatically over the last ten years.
This suggests that clinics are taking advantage of a loophole in the system to benefit their own patients at the expense of others.
Donated organs are normally distributed to patients according to a fixed set of criteria. But there are exceptions: if the donor was too old, or suffered from a virus or cancer, then clinics often refuse to take them. If three different clinics have refused an organ on medical grounds, then it goes into a so-called "accelerated process."
That means that the clinic where the donor is can give the organ to one of its own patients. The idea is to prevent the organ being wasted in individual cases, but in fact more and more organs are being put into the "accelerated process."
The new figures show that between 2002 and 2012, the percentage of livers being expedited in this way jumped from 9.1 percent to 37.1 percent, hearts jumped from 8.4 percent to 25.8 percent, lungs from 10.6 to 30.3 percent, and pancreases from 6.3 percent to as much as 43.7 percent.
According to the Frankfurter Rundschau, this shows that clinics are routinely using the accelerated process to help their own patients at the expense of others elsewhere, effectively bypassing the waiting list.
But the government argues that the figures merely reflect that donors are getting older, so their organs are more often considered unfit. It also pointed out that the directives for pancreases had been altered to reflect this in 2011.
But a 2009 study shows that doctors, state health authorities and health insurers have been unhappy with the accelerated process system for some time.
The study, carried out by the IGES health research institute for the Health Ministry, found that health professionals had already criticized the accelerated process system as lacking transparency.
"The huge increase in these transplants needs an explanation," said Terpe. "After events in Göttingen we have to do everything to ensure that the system isn't being manipulated at another point."
He was referring to the scandal that surfaced last month at Göttingen University Hospital, which suspended two senior doctors accused of falsifying medical records to push certain – possibly paying – patients further up transplant waiting lists.