Illegal Organ Trafficking in Lebanon

This article has been retracted at the request of the Editor-in-Chief.

It is with great regret that readers are notified of the retraction of 3 Experimental and Clinical Transplantation papers from the laboratory of Dr. Maroun M. Abou-Jaoude, of the Department of Surgery, Sacré-Coeur Hospital, Baabda-Hazmieh, Lebanon. The same retraction notice is being applied to 3 papers.1-3

The journal of Experimental and Clinical Transplantation was notified of several cases of ethical misconduct by Dr. Abou-Jaoude with regard to the use of unrelated living donors in his clinical practice, who constitute a large proportion of the patient population examined in the 3 articles mentioned. This is in direct violation of the Declaration of Istanbul on Organ Trafficking and Transplant Tourism endorsed by this Journal and the Middle East Society for Organ Transplantation.

As stated in the Instructions for Authors, one of the conditions of submission of a paper for publication is that authors declare explicitly that their work has been carried out in accordance with the guidelines laid down in the Declaration of Istanbul on Organ Trafficking and Transplant Tourism, and they are required to sign an ethical disclosure form to this effect.

It also has been noted that the article “Abou- Jaoude MM, Nawfal N, Najm R, Shaheen J, Almawi WY. Effect of pretransplant hemoglobin blood level on kidney transplant outcome. Exp Clin Transplant. 2009;7(4):214-217” was republished at a later date in essentially the same form under the following title: “Abou-Jaoude MM , Nawfal N, Najm R, Honeidi M, Shaheen J, Almawi WY. Effect of pretransplantation hemoglobin blood concentration on renal allograft survival and function. Transplant Proc. 2010;42(3)760-762.” This constitutes a serious copyright infringement by the authors and the other journal also has been informed of this situation.

The authors of these articles were contacted on 2 occasions for their comments, but no response was received. Upon due consideration, the Editorial Board has decided to formally retract these 3 papers. In retracting these articles, it is the Editors’ hope to deter other scientists from citing them in the future.

Apologies are offered to readers of the Journal that this was not detected during the submission process.

Organ transplant remains, despite huge advances across the world, the issue of  a lot of taboo in Lebanon where it is rarely practiced, if at all. According to some discussions we’ve had in medical school, Lebanese law is very limiting towards organ transplant.

It doesn’t only require you to approve to have your organs harvested if you end up in some form of accident that leaves you in a vegetative condition where the only thing keeping you alive is a machine, your entire family has to approve as well when the time comes and families rarely reach a unanimous agreement regarding this matter because of the issue’s very thorny nature among them.

For example, my class of 67 medical students had many refuse to sign up as an organ donor despite them acknowledging the beneficial aspects of the premise. Their reason for refusal? Most of them were mainly religious. The devout Muslims, for example, believe that their body belongs to God and they cannot, therefore, harm it in that way. The Christians must have had their reasons as well although none of them actually bothered to explain why to me.

As a result of some mentalities and our laws regarding the matter, the number of organ donors who can actually donate their organs in Lebanon is infinitesimal. The number that was thrown around in that discussion was 4 in Lebanon. That’s 1 for each 1 million Lebanese.

I’m not defending the aforementioned doctors’ practices which are beyond unethical and should have them stripped from their medical degrees. If the Lebanese Order of Physicians is as functional as it claims to be, that’s the first thing it should carry out if these allegations turn out to be true. But could the harsh legal circumstances when it comes to their topic of research in Lebanon have led them to do whatever they did?

However, if you couple the difficulty of organ transplantation in general in Lebanon with the practices of these doctors, which I’m sure are not isolated incidences, the questions asks themselves: what is the extent of organ trafficking in Lebanon? What is the going rate for – say – a kidney from one of Lebanon’s many poor people who can’t afford to have food on their tables?

The sad realization though is that while this issue is more than severe, it goes beyond low on our country’s list of priorities.