The journal Experimental and Clinical Transplantation has retracted three papers by a group of Lebanese researchers who appear to have been engaging in illicit trafficking of human kidneys.

According to the notice:

This article has been retracted at the request of the Editor-in-Chief.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

References

1. 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.

2. Abou-Jaoude MM, Nawfal N, Shaheen J, Daoud Z, Almawi WY. Infectious complications in kidney transplant: A Lebanese perspective. Exp Clin Transplant. 2010;8(2):136-141.

3. Abou-Jaoude MM, Abou-Jaoude WJ, Almawi WY. Sex matching plays a role in outcome of kidney transplant. Exp Clin Transplant. 2012;10(5):466-470.

Only one of the papers — the 2009 one — has been cited at all, and that one just once, according to Thomson Scientific’s Web of Knowledge.

The journal’s editorial office tells us that the general sense of the editors was that the authors were enabling organ tourism:

We were  informed by a member of the Editorial Board who knew Dr. Abou-Jaoude and his work. He informed us that Dr. Abvou-Jaoude is well-known in Lebanon for performing transplants on non-related patients (almost certainly at a fee). On closer examination of the articles we discovered that there were telling sentences (i.e. that 75% of the donors were “emotionally related” to the recipients!) Unfortunately these should have been picked up during the review process but were not. As supporters of the Istanbul Declaration (both the Journal and the society to which it is linked) it was felt that it would be irresponsible to allow the publications to remain as they were. The authors were contacted on two separate occasions for their comments and to give them the opportunity to provide any documents etc. in their defense, but we received no response from any of them. In addition, we also discovered that an almost identical version (ssame study, same patient population, almost identical results) of one of the articles was published 1 year later in Transplantation Proceedings.

The Declaration of Istanbul is intended to prevent organ tourism — seeking body organs from donors in other countries to avoid waiting lists or to save money — states, in part:

 Unethical practices are, in part, an undesirable consequence of the global shortage of organs for transplantation. Thus, each country should strive both to ensure that programs to prevent organ failure are implemented and to provide organs to meet the transplant needs of its residents from donors within its own population or through regional cooperation. The therapeutic potential of deceased organ donation should be maximized not only for kidneys but also for other organs, appropriate to the transplantation needs of each country. Efforts to initiate or enhance deceased donor transplantation are essential to minimize the burden on living donors. Educational programs are useful in addressing the barriers, misconceptions and mistrust that currently impede the development of sufficient deceased donor transplantation; successful transplant infrastructure.

Among its specific tenets are:

Treatment of patients from outside the country or jurisdiction is only acceptable if it does not undermine a country’s ability to provide transplant services for its own population.

Organ trafficking and transplant tourism violate the principles of equity, justice and respect for human dignity and should be prohibited. Because transplant commercialism targets impoverished and otherwise vulnerable donors, it leads inexorably to inequity and injustice and should be prohibited. In Resolution 44.25, the World Health Assembly called on countries to prevent the purchase and sale of human organs for transplantation.

Prohibitions on these practices should include a ban on all types of advertising (including electronic and print media), soliciting, or brokering for the purpose of transplant commercialism, organ trafficking, or transplant tourism.

The retractions carry particular sting for the journal, which noted in an editorial accompanying the removal that:

Many prominent members of the [the Middle East Society for Organ Transplantation (MESOT)] were instrumental in drafting, promoting, and adopting The Declaration, and continue to serve on its board, The Declaration of Istanbul Custodian group. The MESOT and Experimental and Clinical Transplantation have endorsed The Declaration and require all society members and submitting authors to abide by its principles.

We hope that an increase in such policies will help to underscore the importance of ethical issues in the field of transplantation. It is not a foolproof method, as evidenced by the retraction notices published in this issue of Experimental and Clinical Transplantation of articles that did not conform to the guidelines laid down by The Declaration of Istanbul and that, despite our best efforts to identify ethical misconduct, were published in past issues.

Our Society and the Journal will continue to condemn all acts of ethical misconduct that sacrifice integrity and honesty in scientific research, and that above all, compromise patient safety and well-being.

It is imperative that we state, on behalf of the Editorial Board of Experimental and Clinical Transplantation, that we will not accept any submissions that are in conflict with the guidelines of The Declaration of Istanbul, the Helsinki Declaration, and the Committee on Publication Ethics, and we will retract any published materials that are shown to be in violation of these principles.

Experimental and Clinical Transplantation will continue to strive for excellence in scientific publication. The dedicated efforts of the editorial staff and each distinguished member of the Editorial and Review Boards are key to such an achievement, and we thank them for their unparalleled commitment to this excellence.

We also emailed Abou-Jaoude for comment, and Transplantation Proceedings to see if they would be retracting the duplicate paper. We’ll update with anything we learn.