Escalation of tensions between the major hospitals in the center regarding the organ transplants:
if until now the fight has focused on the competition for lung transplants between Sheba and Bilinson, now the hospitals in the center are opposing Sheba Hospital's request to receive permission for liver transplants while claiming "forceful" conduct.
It should be noted that the liver transplant is one of the most profitable treatments for the hospitals - for each liver transplant the hospital receives a million shekels.
Last week, there was a stormy discussion at the Ministry of Health regarding Sheba Hospital's request from the Ministry of Health to authorize it to perform liver transplants. In light of the strong opposition of the professionals, the decision of the Ministry of Health was to reject the request and to hold another discussion on the matter in two years.
Today, liver transplants are performed in Israel only at the Ichilov, Hadassah Ein Kerem, Beilinson and Schneider hospitals.
"Damage to professionalism"
Before the important discussion, an angry letter was sent from the CEO of Ichilov, Prof. Roni Gamzo, who expressed strong opposition to the opening of another transplant center.
The Sheba Hospital and Prof. Gamzo's letter, photo: Danny Maron
Gamzo mentioned that only a year and a half ago, the Director General of the Ministry of Health at the time Prof. Hazi Levy rejected the request to open another center, and that the conditions have not changed and the number of transplants remains stable, so there is no justification for this.
Gemzo alluded to improper pressures applied to the Ministry of Health in the decision-making process.
"I have learned from reliable sources about manipulations, pressures and actions bordering on an apparent violation of the rules of ethics and proper administration by the Sheba management led by Prof. Arnon Afek and Dr. Ado Nachmani," Gamzo wrote to the Director General of the Ministry of Health Prof. Nachman Ash.
"According to the same sources, the manipulations and pressures even border on apparent suspicions of 'give and take' and unceasing forceful lobbying. There will probably be a discussion that is polluted by these actions and over it a cloud of forcefulness and manipulations at the expense of professionalism."
"There is no room for slander"
Following Israel Hayom's request, Prof. Ash sent a letter to Gamzo, in which he commented on his words: "In professional discourse there is no place for personal defamation, but for professional discourse."
He also said: "I cannot refer to information from unknown sources."
Before that, a doctor present at the meeting elaborated: "At Sheba they demanded to open a fourth center in Israel for liver transplants, but the experts in all the hospitals opposed it.
"There is not a large enough amount of liver transplants to distribute them among the hospitals. This will harm the professionalism, experience and mass that the transplant center needs in order to remain on good constant alert. If a third of each hospital is removed - it harms the professional readiness. Only in a few years, when the population grows, There will be room to open another liver transplant center, but not necessarily in the center of the country. The opposition of all parties in the discussion was completely professional."
Prof. Roni Gamzo (archive), photo: Gideon Markovich
In the background of Prof. Gemzo's letter is Dr. Ado Nahmani, one of Israel's top surgeons, who led liver transplants in Ichilov for about a decade and moved from Ichilov to Sheba in the summer of 2020, stating that his ambition is to "develop a liver transplant program in Sheba that will be an integral part of the transplant center."
This is alongside the transfer of another senior doctor, Prof. Eitan Mor, who retired from Bilinson and moved to manage the transplant center in Sheba, while competing with Bilinson in the performance of lung transplants.
As Ran Reznik published in "Israel Hayom", the competition in the field of lung transplants between the two centers was fierce.
At Sheba, they claim that Billinson and the general are exerting terrible pressure and intimidation on the patients, threatening them not to undergo the lung transplant at Sheba and delaying approval for the financing of the procedure.
"Everyone who knows what is happening in this field is called," says a senior medical official in the field of transplants.
"Opening another center for liver transplants will sabotage all centers. In Israel, they are working on a number of transplants that meets the minimum threshold. With 75-70 transplants per year, no hospital will have the minimum required to maintain their quality and safety. This will harm the public and it will harm the training of the next generation."
The official alluded to the involvement of Dr. Nahmani and Prof. Mor in the request and said: "Behind the request are people who in their previous positions opposed the opening of another liver transplant center, and I assume that now they want to engage in it.
Pressure was applied that caused the discussion to take place.
To my delight, those who made the decision are senior doctors without interest and with a huge reputation, who decided to reject the request and made a decision in the best interest of the patients."
Data from the National Center for Transplantation shows that in 2021, 87 liver transplants were performed in Israel.
This is a 20% increase compared to 2020, when there were 72 liver transplants.
Dr. Ado Nachmani, one of the top surgeons in Israel (archive), photo: Sheba Medical Center
Dr. Ado Nahmani of Shiba showed in the discussion that the frequency of animal transplants in Israel is lower than in Egypt and Turkey. In addition to this, Shiba presented a work plan that could lead to an increase of 15-20 percent in the number of livers intended for transplantation in Israel by adopting new technologies and work methods. According to them, this is For saving 10-15 patients a year. At Sheba they presented the possibility of using a tissue lobe transplant from a living donor, an option that is almost not used today in Israel (nine transplants per year).
Also, the possibility of using the technology that is used in the world to "heal" livers that are in a borderline condition for transplantation before the procedure was presented.
In the discussion it was also shown that since Shiba entered the field of lung transplants and since they increased their kidney transplants, there has been an increase in organ transplants in these areas, and that the competition between the centers actually helps patients and does not harm them.
"baseless accusations"
The Sheba Hospital responded: "The field of liver transplants in Israel has been at a standstill for 25 years, while in the world the field has developed. It is our duty to bring patients the most innovative and best practices in accordance with international standards. Any attempt to torpedo a real, professional and substantial discussion by baseless and condescending accusations will only harm in the public of patients.'
The Ministry of Health stated in response: "The additional hearing was held in light of Sheba's request and the presentation of arguments that justified a repeat hearing. To the best of our knowledge, no pressure was exerted on the members of the advisory committee."
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