The control system in the German transplantation structure was expanded and tightened in 2012. This was made possible through the amendment of the law on donation, withdrawal and transfer of organs and tissues (TPG) which was decided by the German parliament in July 2012. The law reform restructured, among other things, the means of control employed by the independent testing and monitoring commission of the German Medical Association, the German Hospital Federation and the Central Statutory Health Insurance Association (GKV). Inspections in the transplantation clinics have, since then, not only been carried out in particular occasions, but also independently of a concrete suspicion. The results are discussed by the testing and monitoring commission and adopted in a commission report.

The reason for the tightening of the control system was the leakage of information about manipulations regarding the allocation of donated organs. Physicians from four German liver transplantation centers were accused of manipulating patient files in order to give preference to their patients. Consequently, the testing and monitoring commission examined the liver transplantations in all 24 liver transplantation programs of the years 2010 and 2011, and submitted its commission report in September 2013. In the transplantation centers in Gottingen, Leipzig, rechts der Isar hospital in Munich and Munster, the examiners found out “serious policy violations of different forms”, which provided clear guidelines for “systematic and deliberate misstatements for the preference of certain patients regarding the allocation of donated organs”. The misstatements concerned for example laboratory findings or data on the need for dialysis. The prosecuting authorities carried out their investigations in the medical centers of Munster, Leipzig, Munich rechts der Isar.

The prosecution against the former chairman of transplant surgery at the University Clinic in Gottingen ended early May 2015 with an acquittal of all charges. He allegedly manipulated patient records accepting, in consequence, that other life-threateningly sick patients would not get a donor organ and possibly die from the lack thereof. For that reason he was charged with eleven cases of attempted manslaughter. In addition, he was charged with three cases of manslaughter as a result of assault and battery. The court argued that the offences were not prosecutable at the time they were committed. It also openly disapproved of the moral position of the doctor even though the acts could not be considered crimes. The attending District Attorney’s Office of Braunschweig that had called for a sentence of eight years in jail and a permanent suspension of the defendant’s medical license has filed an appeal to the Federal Court of Justice of Germany. The case thus ended without prejudice.

There has been a decline in the willingness to donate organs in Germany, which is ascribed to the disclosure of information about the manipulation cases. According to the data of the German Organ Transplantation Foundation, 459 people donated organs after their death in the first half of 2013. In the past years for the same period the numbers were between 548 and 667.