Saturday, May 31, 2008

Will I never be able to retire this blog?

The University of California news had been a bit quieter lately, mostly consisting of follow ups from previous events.

And then, this, from the LA times:

Four Japanese gang figures got liver transplants at UCLA

I read this story, and thought about what to write about it. I've written earlier that, when I tried to tell UCLA patients the risks of anesthesia, my schedule was rearranged so that I wouldn't have any contact with the liver transplant patients. At the time, the rumor among the UCLA surgical and anesthesia residents was that the UCLA living-donor liver transplant recipient survival rate was zero percent in the post-operative period, i.e. that zero percent of the recipients lived more than a year or two after the procedure, if they survived the procedure at all. Some of the residents had a joke about it: they claimed that the mortality rate was only 50% since the living, healthy donors all lived. It was only the recipients of the liver transplants who (according to the rumor) all died. Yeah, OK, it's not really a funny joke. What do you expect from a bunch of chronically sleep deprived science nerds?

Just as a point of reference, successful living donor liver transplants were pioneered by Broelsch, Emond, Thistlethwaite and Heffron at the University of Chicago about half a decade before I was at UCLA. The University of Chicago team had apparently achieved a five year recipient survival rate of near 95% at the time that the rumored UCLA 1 to 2 year recipient survival rate was 0%. Note that I don't have any documentation to verify the UCLA survival rate; just the rumor. However, in light of other rumors that have turned out to be true regarding University of California transplant programs (for example, the rumors that the UC Irvine transplant program was inappropriately turning down organs), I believe it is possible that the rumor I heard at that time was true.

So, I thought my demonstrated willingness to tell people about the risks of, and alternatives to, the procedures they were contemplating, and the location in which they were contemplating them, might have been the reason that my schedule was rearranged to keep me away from the transplant patients.

Now, it appears there might have been another reason. Going back to 2000 (admittedly, after I left UCLA, but that may just be a function of record rot), it appears that UCLA has been selling liver transplants to high ranking Yakuza. (link is to the wikipedia page on Yakuza).

I'm going to write that again:
it appears that UCLA has been selling liver transplants to high ranking Yakuza. I am certainly no expert on the Yakuza, but it's my understanding that, in order to become a high-ranking Yakuza, one must be involved in large scale murder, torture, theft, drug sales, and more. And the State of California, through the University of California, has been selling liver transplants to these people.

I've noted in the past that residency programs can demand unethical or arguably criminal behavior from their residents. Entering into a business arrangement with the Yakuza takes that to a whole new level.

And, there's resident and staff safety to consider. If you work at UCLA, wind up working on a Yakuza, and something goes wrong, what exactly do you think will happen to you and to your family? Do you think the Yakuza handle their disputes through malpractice court? I thought it was bad enough when a street gang found the UCLA operating suites, and tried to get in to finish the job against someone they'd tried to kill. This adds another element. One of the senior anesthesia residents in the year I was at UCLA was allegedly found dead in a hospital bathroom. This connection to the Yakuza adds another set of possible reasons for that unexpected death.

Finally, I can't help but note the disparity in treatment between what the University of California offered to these alleged Yakuza (including rapid transplant, and including house calls, from Los Angeles to Japan, for alleged Yakuza in Japanese prison) and the University of California treatment of people with liver disease in the UC Irvine / UC San Diego transplant program (where the surgeon listed as UC Irvine's transplant surgeon was actually on staff at UC San Diego almost 100 miles away, and was allegedly not generally available to the patients at UC Irvine). The disparity is striking, to say the least.

So, as I noted, I've been thinking about this newly documented connection between UCLA and the Yakuza. Though I've just written this post on the topic, I still feel that the right words to describe all the implications of this may not exist. So, I'm just going to repeat this:

The State of California, through the University of California, has apparently been selling liver transplants to the Yakuza.

It just keeps on getting weirder and weirder.

Update: an interesting perspective on Yakuza in the Washington Post: This Mob is Big in Japan.

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