ONE of the world's busiest organ transplant centres prematurely certified patients as dead so that it could harvest their body parts, it has been claimed.

At least 49 seriously-ill patients were declared dead at a teaching hospital in the Czech town of Ostrava before doctors were sure they had passed away, according to hospital documents. One patient allegedly recovered consciousness on the operating table as doctors prepared to remove his organs.

The scandal is the biggest ever to hit the cash-strapped Czech health service. Parliamentarians listened in silence last week as Josef Janacek, an MP, related the gruesome story of an 18-year-old road crash victim taken to the Faculty Polyclinic.

He was diagnosed as brain dead and his "corpse" was handed over to the hospital's transplant centre. Mr. Janacek said: "He was taken to the operating theatre. However, he then began to breathe and cough before surgeons had started to take any organs from him." He alleged that between 1995 and last year, the rules for certifying brain death were disregarded in more than a third of cases and that paperwork on the dead was non-existent or incomplete.

The transplant centre in the north-eastern town of Ostrava claims to be the world's busiest. Its own figures showed there were 47 donors per million inhabitants, double the world average. The high number of transplants led doctors in the resuscitation department to ask questions.

As a result, Jaroslav Lux, the hospital's director, ordered an investigation. The results were chilling. Quite apart from the issue of how many patients might have been alive when declared dead, the report also showed that the hospital had no record of where harvested organs were taken.

Evidence then emerged of unauthorised visits by German, Austrian and Swedish doctors who flew into the local airport at night, drove to the hospital and departed carrying human organs. Dr Lux sent the report to Ivan David, the health minister, last November. For six months nothing happened.

Then without warning, Dr Lux was sacked the day before the Czech parliament was scheduled to debate the transplant centre. The doctor was accused of financial mismanagement. But opposition MPs had received leaked copies of the Ostrava report and used it to attack Mr David. It was widely assumed that Dr Lux was being made a scapegoat.

Ivan Langer, the parliament's deputy chairman, said that Mr David had "fatally failed" at the hospital and that the decision to sack Dr Lux had increased suspicions of a cover-up. He said: "There are really very serious doubts whether everything going on at the transplant centre was carried out according to the rules."

MPs censured the health minister and set up a commission of inquiry. The police and the doctors' association are also investigating. But Mr David remained defiant, saying that the commission would damage public confidence in transplant centres. There was no truth in the Ostrava allegations, he insisted. "I must disappoint those who imagine that something exciting will result from the establishment of this commission."

Transplant experts have rushed to provide reassurance to the public, insisting that the Czech Republic has some of the toughest criteria in the world for ensuring that donors are dead before organs are removed. Under current rules, corpses should only be sent to a transplant team once the victim's brain has been deprived of blood for half an hour. Experts say the brain is irreversibly damaged if blood is cut off for five minutes.