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Wealthy man won't get refund for transplant

Four Canadian hospitals refused to do procedure

From staff and wire reports

An affluent developer in Toronto, who had kidney transplant surgery in Rochester after four Canadian hospitals refused him on ethical grounds, has been refused reimbursement from the Ontario government for the surgery and related costs.

The Globe and Mail newspaper of Toronto reported Monday that Murray Menkes applied for more than $180,000 in refunds from the province's Health Ministry for the 1999 surgery, follow-up care, flights, hotels, meals and other expenses.

The bills were filed with the Health Services Appeal and Review Board. They included about $16,000 in air fares from Miami and Toronto to the Rochester clinic, hotel bills in excess of $19,000, and nearly $1,500 in meals and expenses.

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Menkes, 76, refused to comment.

When Menkes' appeal was dismissed last year, he exhausted all avenues of reimbursement for the transplant surgery that four Canadian hospitals refused to do on ethical grounds. Menkes' live-in housekeeper was to be the donor.

In October 1999, Menkes had the surgery at a Rochester hospital after Mayo Clinic officials were satisfied that the housekeeper, who is now 54, was acting on compassionate grounds.

Mayo Clinic spokesman Tom Huyck said he can't speak for hospitals in Canada, but, at Mayo, a team of physicians, nurses, social workers and psychologists reviews possible living-donor transplants.

"They work as a team on each and every case. They weigh in on every patient that presents themselves in search of a transplant," he said.

Kidney transplants are only undertaken, he said, when patients are suffering from end-stage renal disease. Donors must be involved only through altruism, with an unselfish interest in helping others.

"The ultimate test is, is the donor doing so through purely altruistic reasons, and I guess that's what it comes down to," Huyck said.

Huyck said he must protect patient confidentiality and can't speak about individual patients. But, he said, "this case, and every case of live donor transplantation, has been through the review."

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Huyck said that an internal review process is triggered any time someone inside or outside the Mayo system questions the ethics of a procedure.

But, he said, "when the recipient and the donor emerge healthy from transplantation, we believe it's a success story by any definition."

The housekeeper said that nothing has changed since she donated her left kidney to her employer and that she is still "like a member of the family." She signed an agreement saying she would not be compensated for donating the kidney and that she was doing it on her own initiative, according to the Ontario Health Services Appeal and Review Board.

The case raises the question of whether someone can give a kidney to an employer, upon whom their livelihood depends.

According to Mayo Clinic bills, Menkes spent $145,000 for pre-operation work, surgery and follow-up care for himself and his housekeeper, including $34,000 to remove the kidney; $51,000 for the transplant surgery; and $9,700 for outpatient services.

By seeking reimbursement, Menkes inadvertently made public the story of his housekeeper's donated kidney -- and, now, the exact cost of his medical treatment.

Staff writer Jeff Hansel contributed to this story.

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