Doctor, gang member face arrest over organ donation deal

[Clark]

http://mdn.mainichi.jp/mdnnews/news/20110623p2a00m0na015000c.html

Doctor, gang member face arrest over organ donation deal

Police are poised to arrest a 55-year-old doctor and four other suspects over suspicions that the doctor paid a yakuza gang member and other parties 10 million yen in exchange for an organ that he needed for a transplant, it has been learned.

Facing arrest are a 55-year-old doctor operating a medical clinic in Tokyo's Edogawa Ward, the doctor's 48-year-old wife, a 37-year-old female restaurant worker, a 50-year-old member of a gang affiliated with the Sumiyoshi-kai yakuza group and a 47-year-old former member of a gang affiliated with the same yakuza group. The five are suspected of violating the Organ Transplant Law, which bans payments for organ donations.

It is the second time for police to uncover such a case, following a separate case at Uwajima Tokushukai Hospital in Ehime Prefecture in 2006. However, this case is the first for police to uncover the involvement of a gang member.

Since ethics guidelines supplied by the Japan Society for Transplantation generally restrict living-donor kidney transplants to those between family members, the doctor, who had been diagnosed with chronic kidney failure, apparently faked the adoption of the former gang member and prepared for a transplant at a general hospital in Tokyo's Itabashi Ward. However, he ran into trouble over payment at the last minute, and the operation was called off. It is believed that the doctor later received an organ from a separate donor.

Investigators said the doctor was diagnosed with chronic kidney failure in August 2005. He started receiving treatment though an external dialysis device to remove toxins through his blood, but he required treatment two or three times a week, with each session lasting several hours.

A transplant surgeon pointed out to the doctor that dialysis treatment could disrupt his life and his work, and although some patients continue dialysis treatment for several years, the doctor decided to get a transplant.

In February 2007, the doctor registered with the Japan Organ Transplant Network, and waited for a kidney from a dead person. However, the demand for organs far exceeds supply and patients are forced to wait 15 years on average to get an organ from someone who has been declared dead.

Investigative sources said that at one stage the doctor had planned to go to the Philippines to undergo a transplant using an organ from a living patient. However, after receiving international criticism over the practice of poor people supplying organs for money, the Philippine government in June 2008 banned nationals from supplying organs to foreigners. This apparently forced the doctor to give up the idea of getting a transplant there.

In the summer of 2009, he discussed his situation with a restaurant worker he knew, and the worker introduced him to the former yakuza through the 50-year-old gang member, with whom she was living at the time.

Investigators said that between October 2009 and April 2010, the doctor and his wife paid 10 million yen in six installments to the restaurant worker, the gang member, who was serving as an intermediary, and the former gang member in exchange for having the former gang member supply a kidney. Suspicions have arisen that the doctor faked the adoption of the former gang member, submitting paperwork to the Edogawa Ward Office in January 2010 to meet the Japan Organ Transplant Network's guidelines.

Though the doctor eventually gave up on the idea of receiving an organ from the former gang member, the Organ Transplant Law bans people from giving or receiving money for organ donations or making promises to exchange money, and people's actions can be judged illegal even if the operation does not go ahead. Violations of the law carry a penalty of up to five years' imprisonment or a fine of up to 5 million yen.

Click here for the original Japanese story http://mainichi.jp/select/today/archive/news/2011/06/23/20110623k0000e040066000c.html

(Mainichi Japan) June 23, 2011

[Clark]

http://www.yomiuri.co.jp/dy/national/T110623005796.htm

Organ revelation tied to greed

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[Clark]

http://mdn.mainichi.jp/mdnnews/news/20110624p2a00m0na012000c.html

Hospital fails to detect fake adoption for illegal kidney transplant deal

The June 23 arrest of five over a deal for a kidney transplant, including a doctor and former yakuza gangster, has raised fears of inadequate donor screening and organized crime involvement in live-donor organ transplants.

The arrests came four years, eight months after a couple was apprehended over an illicit living-donor kidney transplant at Uwajima Tokushukai Hospital in Ehime Prefecture -- then the first such arrests under the Organ Transplant Law.

In the latest case, Toshinobu Horiuchi, a 55-year-old doctor, and the potential donor, Fumihiko Sakagami, a 48-year-old former gangster, faked an adoption, leading the Itabashi Chuo General Hospital to give the go-ahead for a transplant operation. Furthermore, the man who allegedly brokered the deal turned out to be a member of a major crime syndicate.

A medical expert called the case "the worst development imaginable" as it contravened ethics guidelines set by the Japan Society for Transplantation (JST), which generally restrict living-donor kidney transplants to family members. It also comes during a cadaveric donor organ shortage, further spurring fears it may lead to growth in the illegal organ trade.

The Organ Tranplant Law makes no mention of regulations for selecting donors for living-donor transplants. However, the JST added an addendum on living-donor kidney transplants to its ethics guidelines in the aftermath of the Uwajima Tokushukai case in October 2006, in which a donor was slapped with a 1 million yen fine.

Under the tighter guidelines, a psychiatrist and other medical experts appointed by an ethics panel at a hospital performing transplants are required to confirm a donor's willingness to donate his or her kidney, and verify the potential donor through government-issue photo ID.

The guidelines have, however, failed to prevent another kidney trade scandal.

To ban payment for human organs, the JST ethics guidelines limit live organ donor transplants to blood relatives up to six times removed, and in-laws up to three times removed. Screening is left up to individual medical institutions.

"If all relevant documents are presented, it's difficult to question a patient desperate for a transplant and his or her family," medical officials said.

Crime syndicates and other organized criminal groups tend to ask heavily indebted men and women through loan sharks to provide organs. Tactics such as fake marriages and adoptions are not uncommon in various criminal cases, but lax screening of family ties may be at serious levels.

JST spokesman Kenji Yuzawa said, "If you check the age differences between the two men, it's obvious that the adoption was intended for an organ transplant. The biggest problem was that transplant preparations were already under way."

Medical experts, meanwhile, say that some European countries have a third-party entity to screen transplant applications.

[Clark]

http://mdn.mainichi.jp/mdnnews/news/20110713p2g00m0dm102000c.html

Gangster, kidney donor nabbed over doctor's organ trade

Four people including a gangster and a kidney donor were arrested Wednesday on suspicion of engaging in illegal organ trade that resulted in a kidney transplant for a Tokyo doctor, police said.

Matsuo Sakamaki, a 70-year-old gangster, allegedly acted as a middleman between the donor, Tatsuya Horiuchi, 21, and the 55-year-old recipient of his kidney, Toshinobu Horiuchi, they said.

The police plan to serve fresh arrest warrants on the doctor and his wife, Noriko, 48, on Thursday in connection with the alleged organ trade, investigative sources said.

Tatsuya Horiuchi was allegedly asked to provide one of his kidneys in exchange for the write-off of a debt he had owed to the gangster.

He had become the doctor's adopted son prior to the transplant, apparently to disguise the organ transplant as one between living relatives. Under ethics guidelines for doctors, a living donor in an organ transplant must be related to the recipient.

The doctor, who was suffering from kidney failure, had allegedly paid Sakamaki about 10 million yen to find a donor for him, according to investigative sources. The kidney transplant from Tatsuya to Toshinobu was conducted at a hospital in Uwajima, Ehime Prefecture, in July 2010.

The doctor, who directed a clinic in Tokyo's Edogawa Ward, and his wife were arrested last month along with three others on suspicion of offering another gangster 10 million yen for arranging a kidney transplant.

The arrangement did not work out, possibly prompting the doctor to seek a new donor through Sakamaki, the sources said.

[Clark]

http://mdn.mainichi.jp/mdnnews/news/20120126p2g00m0dm125000c.html

Doctor given 3-yr jail term for receiving kidney via illegal trade

A 56-year-old Tokyo doctor was sentenced Thursday to three years in prison for buying a kidney which he received in a transplant operation.

The Tokyo District Court also gave a 30-month jail term to Noriko Horiuchi, the 48-year-old wife of the doctor Toshinobu Horiuchi, for conspiring with her husband to arrange the buying of the kidney, in violation of the organ transplant law.

The doctor, who suffered from kidney failure, paid 8 million yen to a 48-year-old female intermediary in exchange for receiving the organ from a 21-year-old unemployed man in July 2010, according to the ruling.

Presiding Judge Atsuo Wakazono said the couple's act "impaired the principle of equality for organ transplants."

Japan's Organ Transplant Law bans trade in organs, and the ethical guidelines of the Japan Society for Transplantation only permit live organ donation between family members to prevent trade in organs.

The law also bans asking for or promising payment for organs, as well as receiving commission for mediating such transplants, with the aim of ensuring equal opportunity for organ recipients and voluntary donations based on humanitarian spirit.

Wakazono said the behavior of the defendants ran counter to the basic philosophy of the transplant law, and that he "finds no grounds for clemency" for Toshinobu Horiuchi, who "selfishly committed a crime by taking advantage of his financial ability, despite being a doctor."

Wakazono also said Noriko Horiuchi was "actively involved in the conspiracy by serving as a liaison between her husband and gangsters," who mediated the kidney transplant.

Prosecutors had sought prison terms of four years for the husband and wife, both of whom admitted to the charges and called for a suspended sentence.

According to the ruling, Toshinobu Horiuchi paid 10 million yen to a 51-year-old member of a crime organization and others between October 2009 and April 2010 after they introduced a potential kidney donor to him. But the planned transplant operation was cancelled after the gangster demanded more money.

The doctor then asked another crime organization member to find a new donor and received the organ from the 21-year-old man, who was registered as Horiuchi's adopted son prior to the surgery, apparently to disguise the transplant as one between living relatives.

Seven other people were indicted for having been involved in the organ trade conspiracy. Of them, five had their guilty sentences finalized and two are appealing convictions.