Doctor at UTHSC at Houston under investigation for manipulating liver transplant patient list

[bolverk 29680]

I cannot imagine the motive here.

Texas Surgeon Is Accused of Secretly Denying Liver Transplants
A Houston hospital is investigating whether a doctor altered a transplant list to make his patients ineligible for care. A disproportionate number of them have died while waiting for new organs.

For decades, Dr. J. Steve Bynon Jr., a transplant surgeon in Texas, gained accolades and national prominence for his work, including by helping to enforce professional standards in the country’s sprawling organ transplant system.

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

Memorial Hermann-Texas Medical Center in Houston, where Dr. Bynon oversaw both the liver and kidney transplant programs, abruptly shut down those programs in the past week while looking into 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 changing patient records. That effectively denied the transplants, the hospital said. Officials identified the physician as Dr. Bynon, who is employed by the University of Texas Health Science Center at Houston and has had a contract to lead Memorial Hermann’s abdominal transplant program since 2011.

It was not clear what could have motivated Dr. Bynon. Reached by phone on Thursday, he referred questions to UTHealth Houston, which declined to comment. Dr. Bynon did not confirm he had admitted to altering records.

cont'd

Spoiler

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

In recent years, a disproportionate number of Memorial Hermann patients have died while waiting for a liver, data shows. Last year, 14 patients were taken off the center’s waiting list because they either died or became too sick, and its mortality rate for people waiting for a transplant was higher than expected, according to the Scientific Registry of Transplant Recipients, a research group.

This year, as of last month, five patients had died or become too sick to receive a liver transplant, while the hospital had performed three transplants, records show. The investigation is in early stages, and it was unclear if possible changes to the waiting list actually resulted in a patient not receiving a liver. A hospital spokeswoman said the center treated patients who were more severely ill than average.

The U.S. Department of Health and Human Services said in a statement that it was also investigating the allegations. So is the United Network for Organ Sharing, the federal contractor that oversees the country’s organ transplant system.

“We acknowledge the severity of this allegation,” the H.H.S. statement said. “We are working diligently to address this issue with the attention it deserves.”

Officials began investigating after being alerted by a complaint. An analysis then found what the hospital called “irregularities” in how patients were classified on a waiting list for liver transplants. 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 found patients had been listed as accepting only donors with ages and weights that were impossible — for instance, a 300-pound toddler — making them unable to receive any transplant.

Other transplant surgeons said if the list was tampered with, patients would not be aware of changes in their status.

“They’re sitting at home, maybe not traveling, thinking they could get an organ offer any time, but in reality, they’re functionally inactive, and so they’re not going to get that transplant,” said Dr. Sanjay Kulkarni, the vice chair of the ethics committee at the United Network for Organ Sharing. “It’s highly 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, or when they began. It said the issues affected only the liver transplant program, but the hospital also closed the kidney transplant program because it was led by the same doctor.

Dr. Bynon, 64, has spent his career in abdominal transplants, and is considered one of the early 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 his patient 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 the programs at Memorial Hermann has surprised many in the transplant community because it is extremely rare for a program to be suspended over ethical issues.

At the time it shut down its programs, Memorial Hermann had 38 patients on its liver transplant waiting list and 346 patients on its kidney list, according to the hospital.

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

 

[HenryJames 66058]

Sounds like DEI.

[Bevo 13577]

4 minutes ago, bolverk said:

I cannot imagine the motive here.

Texas Surgeon Is Accused of Secretly Denying Liver Transplants
A Houston hospital is investigating whether a doctor altered a transplant list to make his patients ineligible for care. A disproportionate number of them have died while waiting for new organs.

For decades, Dr. J. Steve Bynon Jr., a transplant surgeon in Texas, gained accolades and national prominence for his work, including by helping to enforce professional standards in the country’s sprawling organ transplant system.

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

Memorial Hermann-Texas Medical Center in Houston, where Dr. Bynon oversaw both the liver and kidney transplant programs, abruptly shut down those programs in the past week while looking into 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 changing patient records. That effectively denied the transplants, the hospital said. Officials identified the physician as Dr. Bynon, who is employed by the University of Texas Health Science Center at Houston and has had a contract to lead Memorial Hermann’s abdominal transplant program since 2011.

It was not clear what could have motivated Dr. Bynon. Reached by phone on Thursday, he referred questions to UTHealth Houston, which declined to comment. Dr. Bynon did not confirm he had admitted to altering records.

cont'd

  Reveal hidden contents

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

In recent years, a disproportionate number of Memorial Hermann patients have died while waiting for a liver, data shows. Last year, 14 patients were taken off the center’s waiting list because they either died or became too sick, and its mortality rate for people waiting for a transplant was higher than expected, according to the Scientific Registry of Transplant Recipients, a research group.

This year, as of last month, five patients had died or become too sick to receive a liver transplant, while the hospital had performed three transplants, records show. The investigation is in early stages, and it was unclear if possible changes to the waiting list actually resulted in a patient not receiving a liver. A hospital spokeswoman said the center treated patients who were more severely ill than average.

The U.S. Department of Health and Human Services said in a statement that it was also investigating the allegations. So is the United Network for Organ Sharing, the federal contractor that oversees the country’s organ transplant system.

“We acknowledge the severity of this allegation,” the H.H.S. statement said. “We are working diligently to address this issue with the attention it deserves.”

Officials began investigating after being alerted by a complaint. An analysis then found what the hospital called “irregularities” in how patients were classified on a waiting list for liver transplants. 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 found patients had been listed as accepting only donors with ages and weights that were impossible — for instance, a 300-pound toddler — making them unable to receive any transplant.

Other transplant surgeons said if the list was tampered with, patients would not be aware of changes in their status.

“They’re sitting at home, maybe not traveling, thinking they could get an organ offer any time, but in reality, they’re functionally inactive, and so they’re not going to get that transplant,” said Dr. Sanjay Kulkarni, the vice chair of the ethics committee at the United Network for Organ Sharing. “It’s highly 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, or when they began. It said the issues affected only the liver transplant program, but the hospital also closed the kidney transplant program because it was led by the same doctor.

Dr. Bynon, 64, has spent his career in abdominal transplants, and is considered one of the early 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 his patient 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 the programs at Memorial Hermann has surprised many in the transplant community because it is extremely rare for a program to be suspended over ethical issues.

At the time it shut down its programs, Memorial Hermann had 38 patients on its liver transplant waiting list and 346 patients on its kidney list, according to the hospital.

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

 

Interesting - I wonder if He thought some patients were more deserving than others but the forms didn't allow him to make the decision properly. The only other motive would be some sort of bribery system. Maybe malice would be another possible motive. It should be an interesting investigation.

[BabaYaga 15298]

I can see moving patients up - ala, some Hallmark movie of a dying kid, but moving people back?  

Bribery seems valid.  Follow the money.  Of course if you have deep enough pockets, could you go abroad?

[Brisketexan 105144]

Perhaps he was just diverting livers to another location....where they could be served with some fava beans and a nice chianti?

 

 

 

[lucious leftfoot 126]

 

[chainsaw 9869]

Extreme Measures.

[Steel Shank 9425]

Maybe he moved the Dutch patients down on the list.

[Nice Guy Eddie 13512]

1 hour ago, BabaYaga said:

I can see moving patients up - ala, some Hallmark movie of a dying kid, but moving people back?  

Bribery seems valid.  Follow the money.  Of course if you have deep enough pockets, could you go abroad?

Moving someone down is effectively moving someone else up. It doesn't mean that he's taking money from the patients moving up, but rather he thinks they are better candidates. I'm sure that doctors can believe they are smarter than the predetermined rules (and they may be right) but its dangerous to act on that belief.

[BabaYaga 15298]

2 minutes ago, Nice Guy Eddie said:

Moving someone down is effectively moving someone else up

Time is a flat circle?

[CoTex 1160]

Steve Jobs was diagnosed with pancreatic cancer in 2003, and I understand he lived in California at that time, and all relevant times.  In April 2009, miracle of all miracles, he undergoes a liver transplant in... Memphis.  I think that's about 7 states and 2,000 miles away from his home.   He dies 30 months later of... pancreatic cancer.

If I rolled into a liver transplant program with pancreatic cancer, what do you think my odds are of getting a spot on the list?  Ever making it to the top of the list?

I'm going with "not good Bob."

You cannot convince me that all of these transplant programs are run cleanly.  Money or connections will get you a better spot in line at certain programs.  Stevie Jobs didn't go to Memphis for the ribs and ocean sunsets.

[chainsaw 9869]

If I am remembering right, he also refused a lot of good medical advice because it was "western"

[Wally Fairway 5550]

1 hour ago, HenryJames said:

Sounds like DEI.

more like DIE

[0xdeadbeef 1651]

29 minutes ago, chainsaw said:

If I am remembering right, he also refused a lot of good medical advice because it was "western"

Basically Jobs refused to have surgery when they found the cancer by chance very early on and it was still treatable. Alt medicine didn't do diddly and when he did go for the surgery like six or nine months later, it had spread and was no longer really treatable.   Similar to the King or England who is treating his cancer with "herbs and potions". Good luck with that. 

 

 

As for Dr. Bynon, the transplant doctor in this thread,  I have a gut feeling that it's not going to turn out to be just because he thought someone else had a better chance. I'm guessing that all the people he moved down are going to have something in common:  They're going to be all blacks, or all women, or all liberals, or something like that that is going to make the good doctor look much worse. 

[bolverk 29680]

Houston Chronicle article about this. The one additional detail (bolded) from this one is that the number of transplant patients dying each year keeps increasing.

Memorial Hermann doctor made 'inappropriate changes' to transplant patient records, hospital says

Memorial Hermann-Texas Medical Center has found evidence that a doctor was manipulating records for liver transplant candidates, potentially preventing some patients from receiving life-saving organs, according to a statement from the health system.

The hospital declined to identify the doctor. The New York Times reported he is Dr. J. Steve Bynon, a prominent surgeon who, in 2011, took over the hospital’s abdominal transplant program, which includes kidney and liver operations. Bynon could not immediately be reached for comment Thursday.  

The hospital said the “inappropriate changes… effectively inactivated the candidates on the liver transplant waiting list. Subsequently, these patients did not/were not able to receive organ donation offers while inactive.” 

The allegations are a blow to Memorial Hermann, one of the largest hospitals in the country and the oldest in the Texas Medical Center, and to hundreds of patients awaiting a transplant there. Despite its size, the hospital’s liver transplant center is one of the smallest in Texas, having performed 30 transplants last year, according to federal data. 

Memorial Hermann halted its kidney transplant program on Tuesday, four days after it inactivated its liver transplant program. Both stoppages were due to “a pattern of irregularities” with liver donor acceptance criteria, the hospital said at the time. 

A hospital investigation found problems with information entered into a database used to match donor organs with patients, officials said Thursday. The information included the patient’s age and weight. The hospital did not provide further details. 

Memorial Hermann has seen an increasing number of its liver transplant candidates die on the wait list or become too sick for a transplant in recent years, according to data from the Organ Procurement Transplantation Network. The data shows that four patients fell into that criteria in 2021, followed by 11 in 2022 and 14 in 2023. Five patients have died or become too sick to transplant so far this year, while the hospital has performed only three liver transplants.

The “irregularities” were limited to liver transplants, the hospital previously said, but kidney transplants were halted because they share the same leadership. Multiple federal agencies, including the Centers for Medicare and Medicaid Services and the Health Resources and Services Administration, have also been deployed to investigate, a statement from the U.S. Department of Health and Human Services said. 

Memorial Hermann has not said how long both programs will remain shut down. The hospital said it was working with patients and their families to get them care. Last week, the hospital began contacting the 38 patients on the liver program transplant list. This week, the hospital started reaching out to each of the 346 patients on the kidney program transplant list.

Candidates on the waiting list do not receive organ offers when a transplant program is inactive, but they do continue to accrue waiting time, a United Network for Organ Sharing spokesperson said.

Candidates may be on the waiting list at multiple transplant programs or transfer their waiting list time from one program to another, though each transplant program has its own criteria for evaluating and accepting candidates, the UNOS spokesperson said.

Houston Methodist, Baylor St. Luke’s Medical Center and the Michael E. DeBakey Veterans Affairs Medical Center also offer transplant programs in Houston.
A Houston Methodist spokesperson said that it had received calls from several liver transplant candidates and was “actively working” to get them into the hospital’s transplant program.

[Neonmoon 38129]

2 hours ago, bolverk said:

I cannot imagine the motive here.

[F250 28777]

 

[gofuckyourself 8240]

You want a liver? I can get you a liver, believe me. There are ways, Dude. You don't wanna know about it, believe me. Hell I'll get you a liver by 3 o'clock this afternoon--with fava beans. These fucking amateurs.

[tokamak 6430]

What a weird story. Manipulating the list so his numbers look better maybe?

[ABSR 5313]

2 hours ago, Nice Guy Eddie said:

Moving someone down is effectively moving someone else up. It doesn't mean that he's taking money from the patients moving up, but rather he thinks they are better candidates. I'm sure that doctors can believe they are smarter than the predetermined rules (and they may be right) but its dangerous to act on that belief.

I'm curious if this is something of his motive, where he adjusted it to move patients with a better chance of success and lower mortality outcomes up the list, and consequently avoiding those with statistically a lower chance of success.  This would make him "more successful" in conducting these types of operations and likely make him "more successful" than his peer group.  Doctors ego's and whatnot.

[Dahobbs 17534]

14 minutes ago, tokamak said:

What a weird story. Manipulating the list so his numbers look better maybe?

 

7 minutes ago, ABSR said:

I'm curious if this is something of his motive, where he adjusted it to move patients with a better chance of success and lower mortality outcomes up the list, and consequently avoiding those with statistically a lower chance of success.  This would make him "more successful" in conducting these types of operations and likely make him "more successful" than his peer group.  Doctors ego's and whatnot.

That would make sense except for the fact that it also made the program he was the director of look much worse. 

[CooterBrown 18013]

3 hours ago, Steel Shank said:

Maybe he moved the Dutch patients down on the list.

[chainsaw 9869]

2 hours ago, 0xdeadbeef said:

Basically Jobs refused to have surgery when they found the cancer by chance very early on and it was still treatable. Alt medicine didn't do diddly and when he did go for the surgery like six or nine months later, it had spread and was no longer really treatable.   Similar to the King or England who is treating his cancer with "herbs and potions". Good luck with that. 

 

 

As for Dr. Bynon, the transplant doctor in this thread,  I have a gut feeling that it's not going to turn out to be just because he thought someone else had a better chance. I'm guessing that all the people he moved down are going to have something in common:  They're going to be all blacks, or all women, or all liberals, or something like that that is going to make the good doctor look much worse. 

That would be fucked up

[KYHorn 17067]

Maybe he is just lazy! "Let's see, do I want to transplant another liver or make some time to golf?"

[Bevo&Pevo 5150]

I have a spare kidney and lung.  B+ blood type used but good condition.  Let's start the bidding at 20K.

[Armybrat 40849]

2 hours ago, chainsaw said:

That would be fucked up

That’s how my DIL died of breast cancer 11 years ago.
Totally unnecessary. 🤬

[Sawbonz 27564]

5 hours ago, tokamak said:

What a weird story. Manipulating the list so his numbers look better maybe?

This is what I think. Patients can technically be a valid candidate but still higher risk to have complications or mortality than other candidates. If he can figure out a way to cherry pick then his success rate goes up relative to other centers 

[Billy Pilgrim 1963]

Transplant surgeons in general are weird and usually assholes in my experience.

[futureman 22464]

7 hours ago, KYHorn said:

Maybe he is just lazy! "Let's see, do I want to transplant another liver or make some time to golf?"

just snake a tube down her nose and I’ll be there in… four or five hours. 

[RPM 26321]

I wonder if there is some ethnic, moral or religious factor he was using to rate the patients. i.e. you don't go to X church, you don't get a liver.

[Lat22 4014]

The demographics of who got them vs who didn’t will tell the tale. If they have the balls to release those findings. 

[Bevo 13577]

On 4/12/2024 at 1:15 PM, ABSR said:

I'm curious if this is something of his motive, where he adjusted it to move patients with a better chance of success and lower mortality outcomes up the list, and consequently avoiding those with statistically a lower chance of success.  This would make him "more successful" in conducting these types of operations and likely make him "more successful" than his peer group.  Doctors ego's and whatnot.

Maybe, but such a move would also save lives.

[Jkwellborn 6702]

Maybe he was letting them die to get more organs to transplant. Kinda like planting seeds in farming.

[closetohumping 17442]

On 4/12/2024 at 8:38 PM, Billy Pilgrim said:

Transplant surgeons in general are weird and usually assholes in my experience.

Seems like the more specialized the doctor, the bigger the asshole

[ABSR 5313]

23 minutes ago, closetohumping said:

Seems like the more specialized the doctor, the bigger the asshole

What we need next is for Surly to opine about what kind of car he drives.  Then we will know how truly villainous he is.

[Bevo 13577]

In law school did y'all find that the bigger the gunner the bigger the asshole?

[MrBig 5398]

On 4/13/2024 at 8:59 AM, Lat22 said:

The demographics of who got them vs who didn’t will tell the tale. If they have the balls to release those findings. 

I’m sure they won’t be as much outrage if the fatties and olds got bumped, but if it’s for things like race or income level then people will be pissed. 

[Orale 1087]

16 minutes ago, Bevo said:

In law school did y'all find that the bigger the gunner the bigger the asshole?

They were definitely bigger morons. 

[EastHorn 281]

24 minutes ago, MrBig said:

I’m sure they won’t be as much outrage if the fatties and olds got bumped, but if it’s for things like race or income level then people will be pissed. 

The poor people don’t make the list. The first thing you do is a “wallet check” and make sure they can afford all the care. 

[MrBig 5398]

Not directly related but John Oliver did a story a few months ago about how fucked up and disorganized the whole transplant industry is in the US.

 

[closetohumping 17442]

10 minutes ago, EastHorn said:

The poor people don’t make the list. The first thing you do is a “wallet check” and make sure they can afford all the care. 

No gubment insurance allowed

[EastHorn 281]

28 minutes ago, closetohumping said:

No gubment insurance allowed

I mean I have seen Medicaid in an illegal alien who paid taxes every year and had a TIN get an organ after fundraising 50k in an escrow account. So yea it’s wild. 
 

If you are too old you just don’t get listed. 

[Jkwellborn 6702]

No gubment insurance allowed

John Q does not appreciate this.

[Gatorubet 30239]

On 4/12/2024 at 10:24 AM, Steel Shank said:

Maybe he moved the Dutch patients down on the list.

that would end the investigation

[Gatorubet 30239]

1 hour ago, EastHorn said:

The poor people don’t make the list. The first thing you do is a “wallet check” and make sure they can afford all the care. 

But when they pass, their other organs are harvested and supplied to richer people. It’s the circle of life.

[Bevo 13577]

2 hours ago, EastHorn said:

I mean I have seen Medicaid in an illegal alien who paid taxes every year and had a TIN get an organ after fundraising 50k in an escrow account. So yea it’s wild. 
 

If you are too old you just don’t get listed. 

I have a patient on Medicaid with a new liver. Is that rare?

[EastHorn 281]

8 minutes ago, Bevo said:

I have a patient on Medicaid with a new liver. Is that rare?

Not necessarily. I feel like what weeds most people out who are poor are socioeconomic things earlier like access to a doctor and regularly seeing a doctor which all go into the evaluation (I’ve had patients who are always late to doctor since they take the bus and people who evaluate them get nervous that it means they are unreliable.  Then you have to go to bat for them). If you are poor and can’t afford gas or trips to doctor to be evaluated then that weeds people out. So if you have Medicaid but are getting access then totally possible.

Part of the justification is we shouldn’t be giving organs to people who can’t take care of them after the surgery.  You can define “can’t take care of them” how you like.  It’s an interesting world.  

 

 

[Sawbonz 27564]

42 minutes ago, Bevo said:

I have a patient on Medicaid with a new liver. Is that rare?

Not sure about Medicaid or livers but Medicare covers kidney transplants. I had an employee with an adult son who ended up with end stage renal failure on dialysis. He was kind of a fuckup who had developed type I diabetes as a teenager and refused to control it (apparently a common way for these kids to rebel).

Anyway in his early 30s his kidneys quit working. Dialysis is one of the things that qualifies you for Medicare immediately. He got his shit together, quit smoking and drinking and got his sugars under control, and got on the transplant list. 

As they learned more about it, they found out that, while Medicare does pay for a transplant, once you have the new kidney and it’s working, you lose your Medicare coverage (no dialysis, no Medicare). Anti rejection meds alone are $1000 or so a month, plus labs and doctor visits, insulin and supplies, and high likelihood of periodic hospital stays due to complications from the transplant or the immunosuppressive meds. 

Dude was divorced and basically unemployable, at least as far as getting a job w insurance benefits. He wound up refusing further dialysis and going on hospice. Died in about 3 weeks and left 2 young boys. 

Edited April 14 by Sawbonz

[ChiTownDoc 21154]

On 4/12/2024 at 6:28 PM, 0xdeadbeef said:

Basically Jobs refused to have surgery when they found the cancer by chance very early on and it was still treatable. Alt medicine didn't do diddly and when he did go for the surgery like six or nine months later, it had spread and was no longer really treatable.   Similar to the King or England who is treating his cancer with "herbs and potions". Good luck with that. 

Fuck.  Can Elon get some of that early easily treatable pancreatic cancer?  I’m sure he would follow the science - as he sees it.  Please, dear baby Jesus, let it happen…

 

 

 

 

 

 

 

[Beau Vine 54230]

On 4/13/2024 at 1:50 AM, RPM said:

I wonder if there is some ethnic, moral or religious factor he was using to rate the patients. i.e. you don't go to X church, you don't get a liver.

Then the Baptists would get all the liver transplants...