The Department of Health announced on Sept. 29 that Ko Wen-je (柯文哲) alone should be held responsible for the transplant of organs from an HIV-positive donor at National Taiwan University Hospital in August. The department added that Ko, the former director of the hospital’s organ transplant task force, could receive severe punishment. This is not a fair decision.
Many patients with little time left are waiting for donor transplants, and they can do nothing but wait and see whether they will be lucky enough to receive the organ they need. Because supply falls far short of demand, the use of organs from HIV-infected donors is already allowed in the US. The reason for this is that patients who require a new heart, lung or liver normally have less than six months to live, a year at the most.
There is no difference in the success rates of transplants of organs that are infected with HIV and organs that are not. Once a transplant is successful, even if the organ is infected with HIV, the life expectancy from infection to death is generally between 10 and 20 years, thus extending life expectancy by 10 times or more. That means that those who received heart, lung and liver transplants at the hospital were beneficiaries, not victims.
Uremia patients who are being kept alive by hemodialysis or peritoneal dialysis may not live for 10 years, which means that it is not even clear that someone who receives a kidney transplant from an HIV-positive donor is a victim.
An organ transplant requires teamwork and cooperation, and adherence to standard operating procedure. Requiring that Ko personally must set up a check list and interpret the test results is both unreasonable and unfeasible, nor are there any such regulatory requirements in international transplant medicine. In order to improve the vitality of transplanted organs and preserve their normal functions, every second counts during an urgent organ transplant. Ko did not execute the transplant, and he should not be required to personally set up the check list and interpret the test results.
In a wider sense, blood transfusions are also transplants. If a patient in a state of shock induced by a ruptured ectopic pregnancy and massive abdominal hemorrhage arrives at the emergency room for treatment, the ER doctor on duty sets up the blood test and blood transfusion slip before informing the doctor on duty at the maternity ward that an operation is required. If the wrong blood type is used in the transfusion, should the doctor in charge of the maternity ward be held responsible for not personally setting up the check list and interpreting the test results?
Ko started his career as a heart surgeon. After abandoning surgery, he became the guardian angel of patients at the hosital’s critical care department, where he rescued many people from certain death. He has made immeasurable contributions to the medical field. The most well known case is probably his participation in the rescue of Greater Taichung Mayor Jason Hu’s (胡志強) wife.
Ko is also an outstanding educator in the area of critical care medicine, where he has trained many people. He has made many contributions to the nation, and that he has now been given such an unfair punishment could lead to the future deaths of many people in need of critical care throughout the country. It is a great loss for both state and society, and the health department should set up a new investigation to give Ko Wen-je a just and fair hearing.
Hsieh Yen-yau is deputy superintendent of the Koo Foundation Sun Yat-sen Cancer Center.
Translated by Perry Svensson
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