As a last resort, a lung transplant may save corona patients in critical condition • Dozens of transplants have been performed worldwide, but none in Israel • Background: Clash between Beilinson and Sheba
exposure.
In some corona patients around the world, the disease has caused severe and irreversible destruction of the lungs.
In some countries, including China, the United States, Canada and Austria, several dozen lung transplants have already been performed on Corona patients, as the last possible way to save them after they were in immediate danger of death.
Photo: Knesset Channel
According to publications of hospitals around the world, some of the transplants have succeeded in rescuing some of the patients - but so far not a single lung transplant has been performed on a Corona patient in Israel.
It should be noted that according to the assessments of senior doctors, there are patients who could have undergone the transplant and increased their chances of surviving the disease.
Indeed, in recent weeks an extraordinary struggle has begun regarding the lung transplants for corona patients in Israel.
As part of the struggle, an unprecedented confrontation began over the prestige of hospitals and doctors, which entailed a severe controversy over conflicting medical-ethical approaches.
In addition, unprecedented mutual accusations, including allegations of serious harm to patients and persecution of publicity, were raised between two of the largest and most powerful hospitals in Israel: Beilinson in Petah Tikva - Clalit Central Hospital, where all lung transplants in Israel have been performed in recent years. In Israel, in front of the Sheba Government Hospital in Tel Hashomer - the largest in the country, where a new lung transplant program was opened about six months ago, but so far there has not been a single transplant.
As part of the extraordinary confrontation, which was first revealed here, Beilinson doctors are demanding that the Ministry of Health approve lung transplants in corona patients only under certain restrictions, which in practice will prevent the approval of a lung transplant in Sheba, and perhaps even in Israel.
In Sheba, on the other hand, they accuse Beilinson doctors of trying to torpedo lung transplants for corona patients in Sheba in every way, and that they do so also by advising and persuading the patients' families not to perform lung transplants.
Following the confrontation, a stormy zoom meeting of the members of the Cardiopulmonary Transplant Committee has already taken place at the National Transplant Center, and another meeting is scheduled for October 25, in about a week and a half.
A string of stringent restrictions
As part of the fight, Beilinson's doctors are demanding that lung transplants in Corona patients be performed only with a long list of stringent medical restrictions, including: no more than a month of transplantation from the moment the disease develops;
Ability of the patient to give conscious consent to the transplant;
And a requirement to perform a transplant only in a hospital where there is extensive experience in lung transplantation.
Beilinson also demands that transplants for Corona patients be performed only in a hospital where there is experience with patients who are connected to an Acme device (an artificial heart-lung device).
However, in recent years, Beilinson has performed few such transplants, so according to senior doctors, this means that it will actually be forbidden to perform lung transplants for corona patients in Israel as a whole.
In Sheba Hospital, on the other hand, doctors from the Ministry of Health require them to immediately approve at least four lung transplants in Corona patients, and then, depending on the results of the transplants, determine the plan for further transplants later.
They emphasize that some of the restrictions required by Beilinson go beyond the standard guidelines for transplantation in Corona patients, as published in August this year by the International Organization for Cardiac and Pulmonary Transplantation, and are generally adhered to.
The struggle for lung transplants flared up after about a month and a half ago a request for a lung transplant was received from the family of a corona patient in critical condition, who is hospitalized in Sheba.
However, after contacting Sheba, the family also consulted with Prof. Mordechai Kramer, director of the Beilinson Lung Department.
He advised them not to undergo the transplant, so they informed Sheba that they were asking not to perform the transplant.
Meanwhile, she is hospitalized in critical condition and her lungs are not functioning.
"You canceled her chance to live"
This was followed by an unusual and unusual internal correspondence between the senior officials of the two hospitals.
Prof. Udi Raanani, director of the Sheba Cardiovascular Center, first wrote to Prof. Kramer: "I take this seriously because in your recommendation you closed the door on her only chance to live. "A lung transplant in Sheba, which was established with the blessing of the Ministry of Health, is a fait accompli. You, as a leader in the field in Israel, should complete and congratulate it."
In response, Prof. Kramer wrote to Prof. Raanani: "The recommendation for the patient's family not to undergo the transplant was in my opinion its chances of recovery. In our situation, with so few lung donations and many waiting for a transplant, it would not be wise to perform the transplant. To us for transplantation as the family requested. "
Prof. Kramer of Beilinson added that the senior surgeon who works today in the lung transplant system at Sheba, and was previously one of the leaders of the Beilinson lung transplant system and its founders, "refused when he worked with us to transplant patients over the age of 50 connected to an Acme machine."
Thus, Kramer wondered, "Now he changed his mind just to get a headline in the paper?"
Cold shoulder and cheap politics
Prof. Raanani from Sheba responded sharply to Kramer and claimed that at Sheba Hospital they actually "offered full cooperation with you at all levels. Instead we got a cold shoulder and in the second stage we get cheap politics."
Raanani also claimed that "we also have quite a few testimonies from patients who receive unequivocal hints, to the point of an implicit threat, about the damage they will suffer if they choose Sheba as the medical center that implants them. Medical staff in front of patients in existential medical distress. "
Prof. Kramer wrote about this: "This is a letter full of distortions."
Beilinson Hospital said:
"A seemingly simple solution - a lung transplant that will replace the diseased lungs - is problematic because patients connected to an Acme device are considered complex, and their chances of success in transplantation are low.
Beilinson is the largest transplant center in Israel, and along with the large number of transplants, we have accumulated decades of experience that are also reflected in good quality results in relation to transplant centers around the world.
Opening additional transplant centers without increasing the number of organ donations will reduce the number of transplants in each center and impair the quality of the results.
Therefore, the decision to open another lung transplant center in Israel this year is puzzling. "
Sheba Hospital stated:
"Sheba has a lung transplant program, which provides a solution for patients with serious lung diseases after all other common treatment lines have been exhausted.
Since Sheba has in recent years the richest experience in Israel in the treatment of elderly patients connected to an Acme device, but it is natural that we also examine the possibility of transplantation in such patients in a difficult situation, including corona recoverers.
"Despite the enormous challenge and the high risk involved in these cases, we are confident that Sheba has a leading transplant team, which includes Dr. Milton Sauta, the most experienced lung transplant in the country, and Dr. Liran Levy, who underwent lung transplantation. "The longest internship in the field, at the largest lung transplant center in the world in Toronto. The existence of more than one transplant program in Israel works for the benefit of the patient and will better serve the citizens of Israel."
