A Texas surgeon is accused of secretly denying liver transplants

For decades, Dr. J. Steve Bynon Jr., a transplant surgeon in Texas, has won national recognition and fame for his work, including helping to enforce professional standards in the country's vast organ transplant system.

But officials are now investigating allegations that Dr. Bynon was secretly manipulating a government database to make some of his patients ineligible to receive new livers, potentially depriving them of life-saving treatment.

Memorial Hermann-Texas Medical Center in Houston, where Dr. Bynon oversaw both liver and kidney transplant programs, abruptly ended those programs last week while it investigated the allegations.

On Thursday, the medical center, a teaching hospital affiliated with the University of Texas, said in a statement that a doctor in its liver transplant program had admitted to altering patients' medical records. This effectively denied the transplants, the hospital said. An official familiar with the investigation identified the doctor as Dr. Bynon, who works at the University of Texas Health Science Center at Houston and has been contracted to lead Memorial Hermann's abdominal transplant program since 2011.

It was unclear what might have motivated Dr. Bynon. Reached by phone Thursday, he referred questions to UTHealth Houston. He did not confirm that he admitted to having altered the documents.

On Friday, after this article was published online, UTHealth Houston released a statement to news outlets defending Dr. Byon as “an exceptionally talented and caring physician and a pioneer in abdominal organ transplantation.” The statement said the survival rates of Dr. Bynon's patients who received transplants were among the best in the nation. “Our faculty and staff members, including Dr. Bynon, are assisting with the investigation of Memorial Hermann's liver transplant program and are committed to addressing and resolving any findings identified by this process,” he said.

Founded in 1925, Memorial Hermann is a major hospital in Houston, but has a relatively small liver transplant program. It performed 29 liver transplants last year, according to federal data, making it one of the smallest programs in Texas.

Data shows that in recent years a disproportionate number of Memorial Hermann patients have died while waiting for a liver. Last year, 14 patients were taken off the center's waiting list because they had died or become too ill, and the death rate for people waiting for a transplant was higher than expected, according to the research team Scientific Registry of Transplant Recipients.

This year, as of last month, five patients have died or become too ill to receive a liver transplant, while the hospital has performed three transplants, records show. The investigation is in its early stages and it is unclear whether any changes to the waiting list actually resulted in a patient not receiving a liver. A hospital spokeswoman said the center treated more seriously ill patients than average.

The U.S. Department of Health and Human Services also said it was investigating the allegations. The same goes for the United Network for Organ Sharing, the federal contractor that oversees the country's organ transplant system.

“We recognize the seriousness of this allegation,” the HHS statement read. “We are working diligently to address this issue with the attention it deserves.”

The officers started the investigation after being alerted by a complaint. An analysis then uncovered what the hospital called “irregularities” in how patients were classified on the liver transplant waiting list. When doctors place a patient on the list, they must identify the types of donors they would consider, including the person's age and weight.

Hospital officials said they discovered that patients had been listed as accepting only donors of impossible ages and weights — for example, a 300-pound child — making them incapable of receiving any transplants.

Other transplant surgeons said that if the list had been tampered with, patients would not have been aware of changes in their status.

“They're staying at home, maybe not traveling, thinking they can get an offer of organs at any time, but in reality they're functionally inactive and so they won't get that transplant,” Dr. Sanjay Kulkarni said. , vice chair of the ethics committee of the United Network for Organ Sharing. “It's very unusual, I've never heard of it before, and it's also highly inappropriate.”

The hospital said in its statement that it did not know how many patients were affected by the changes, nor when they began. He said the problems were only with the liver transplant program, but the hospital also closed the kidney transplant program because it was headed by the same doctor.

Dr. Bynon, 64, has spent his career in the field of abdominal transplants and is considered one of the premier practitioners of advanced liver transplants. He spent nearly 20 years at the University of Alabama at Birmingham before moving to Texas in 2011.

Some former colleagues described Dr. Bynon as off-putting and arrogant, while others called him talented and dedicated.

“In my experience, everything he did was about the patient,” said Dr. Brendan McGuire, the medical director of liver transplants at that Alabama program, who worked with Dr. Bynon for more than a decade. “When he transplanted someone, that person was a patient with him for life.”

On its LinkedIn page, the University of Texas Health Science Center once featured a photo of a billboard with Dr. Bynon on it. The sign read: “Dr. Bynon Gives New Life to Transplant Patients.”

Dr. Bynon also served on the Membership and Professional Standards Committee of the United Network for Organ Sharing, which investigates wrongdoing in the transplant system.

Most recently, in December, Dr. Bynon made headlines for performing a kidney transplant for former Lt. Gov. Ben Barnes of Texas.

The closure of programs at Memorial Hermann surprised many in the transplant community because it is extremely rare for a program to be suspended over ethical concerns.

According to the hospital, at the time its programs closed, Memorial Hermann had 38 patients on the liver transplant waiting list and 346 patients on the kidney transplant waiting list.

Officials said they were contacting those patients to help them find new providers.

Roni Caryn Rabin contributed to the reporting. Susan C. Beachy AND Kirsten Noyes contributed to the research.

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