What used to be the stuff only of urban legends, is now known to be true, and its scope is increasing across the globe. That is, the donors of body parts for living donor transplants (such as kidneys, parts of a liver, and the corneas from eyes) are selling their organs to "brokers" who then turn around and sell them to someone who is desperate and will pay for the transplant.
Such commercialization of human organs, called organ trafficking should be no surprise. There is clearly a market comprised of people who need money, and people of means who are willing to spend money for organs. It's a black market, meaning the practice is wholly illegal and secretive. But it's a market all the same, comprised of "haves" on the demand side, and "have nots" on the supply side. Experts from the World Health Organization estimate 11,000 illegal organ transactions took place in 2010.
This "transplant tourism" is surging in popularity, even in the United States, for at least three reasons. First, because the numbers of people who need organs is growing. Second, because the transplant lists, such as those determined by UNOS in the United States are getting longer and longer. And third, because the world economic crisis is forcing people to look at ways they can make money. Selling their organs can put food on the table.
Except for transplants that take place in Iran where human organ sales are condoned, organ trafficking is illegal. However, according to a number of news media sources and the World Health Organization, you'll find plenty of advertising in print and online, offering to buy or sell an organ, usually a kidney. Those sales, and the transplantation, take place while authorities turn a blind eye.
Here's how transplant tourism might work for an American:
Desperate patients who have the means, find organs to purchase, mostly outside the United States. They make contact with a human organ broker in a country such as India, Bengladesh, Pakistan, China, Brazil, Israel, Eastern Europe, the Philippines or Egypt who find a "willing" donor in their own country. The broker then finds a donor by promising lots of money, or an iPad, or a "vacation of a lifetime" to the United States.
Arrangements are made for the donor to travel to a designated hospital usually near where the buyer-receiver lives. The transplantation takes place, and the donor returns home. The buyer-receiver will have paid as much as $200,000 or more to the broker, who then pays the hospital and surgeon, all under the table, of course. The donor may, or may not see all the money he or she was promised. Larger problems loom for donors who are rarely provided with safe medical care after their surgery.
The tourist in these cases is, of course, the donor. But sometimes it happens the other way, where the patient travels to the donor's country to receive an organ. And sometimes both parties travel to a third country.
According to many recent news reports, there are at least a dozen hospitals in the United States where these transplantations are taking place. No hospitals are named, so that statement is difficult to verify, and for obvious reasons, that information won't be available online. These reports all state that the paperwork being provided by brokers seems to indicate the donor is a "close personal friend" of the recipient, even though it's obvious they have no relationship at all.
In 2009, a rabbi from Brooklyn was arrested for what he called "matchmaking" - bringing donors from Israel to the United States to provide kidneys to wealthy Americans. The transplants took place at Mt. Sinai Hospital in New York, which denied any corruption was taking place. The rabbi was sentenced in 2012 to 30 months in prison.
Ethics and Organ Procurement
In addition to being illegal, such buying and selling of human organs raises ethical questions. Most professionals involved in organ transplantation believe that human organs should not be bought or sold under any circumstances. In 2008, a group of transplant specialists convened and penned the Declaration of Istanbul, which declares "human organ commercialization" to be unethical and illegal.
But other professionals have a different viewpoint. They insist that legalizing the trade of human organs would at least make the process safer. By legalizing it, then overseeing it, the people who pay the true price, those who are poor and are selling their organs, would at least get decent medical care afterwards. This debate is taking place in many countries, including the United States and Great Britain. The country of Singapore is considering changing its laws to accommodate for the sale and purchase of organs.
Legal Alternatives for Finding Human Organs
If you are in need of a transplant from a live donor - kidney, cornea or partial liver - there are few legal alternatives to participating in the UNOS priority system. Despite some issues with how the UNOS system works, it is mostly fair and equitable. But that does not help you unless you are one of the easily-measured sickest patients.
The system can be gamed by changing locations, as Steve Jobs showed us in 2009 when he temporarily moved from California to Tennessee where the ratio of organs to sick patients was more favorable.
Some patients, or their family members, have been known to run advertising, like on Craigslist, begging for an altruistic donor. There are several news stories about people who came forward to donate a kidney (human beings have two kidneys, but need only one kidney to live). It is illegal to pay donors or give them gifts.
Of course, the safest and most legal way of getting an organ from a living donor is to have someone in your family who is willing to share if you need a kidney or liver. This may include someone who is strong and healthy, or it may be someone in your family who dies as a designated organ donor, although once a person has died, it may be difficult to make that match within the family.
Some additional links of interest:
• A company called Havocscope tracks black market activity around the world, including organ trafficking.
• News reports about transplant tourism and organ trafficking include:
- From the International Consortium of Investigative Journalists: Human Corpses are Prize in Global Drive for Profits
- From Newsweek and The Daily Beast: Not Just Urban Legend
- From The Independent (UK): Sale of human organs should be legalised, say surgeons
- From Science Daily: Growing Market for Human Organs Exploits Poor
- From The Guardian (UK): Illegal kidney trade booms as new organ is 'sold every hour'