Illegal trafficking of human organs from poor to rich countries threatens to undermine donation programs in industrialized states and worsen a growing shortage, transplant experts said on Monday.
Exploiting poor donors, especially for kidneys, is creating a kind of “medical apartheid” that risks turning public opinion against transplantation schemes and could threaten rich states’ legal donation programs, experts said.
“Organ trafficking and its consequences are of grave concern for transplantation and public trust in medical establishments,” University of Pennsylvania bioethicist Debra Budiani told a conference aimed at a common European policy on transplants.
Andre Kottnerus, chairman of the Netherlands Health Council, said health officials had to speak out more publicly against organ trafficking, which the World Health Organization (WHO) says accounts for up to 10 percent of transplants worldwide.
“As a scientific community, we have to be accountable to society not only for the successes but also for the failures and threats,” he said.
Transplantation is a growing problem in rich states because waiting lists are growing far faster than the supply of organs.
Kidneys are in dramatically short supply, prompting a black market where the poor receive small sums for donating kidneys sold to rich recipients for many thousands of dollars.
There are about 95,000 people waiting for kidney transplants in the United States and about 65,000 in Europe, said Michael Bos of the Netherlands Health Council. Annual transplant rates run about 25,000 in the United States and 16,000 in Europe.
“Something like 10,000 kidneys are transplanted every year from living donors who are paid sometimes small amounts,” Bos said, calling the situation “a kind of medical apartheid.”
“This goes from the poor to the rich, from underdeveloped to rich countries, from black and colored people to whites and often from women to men.”
The Geneva-based WHO said last Friday “transplant tourism” was rising, as rich patients bypassed bans on buying organs at home by traveling abroad to receive kidneys from poor donors.
In one such case, a New Yorker paid $60,000 to receive a kidney in a South African hospital from a Brazilian who was paid $6,000 for it, Francis Delmonico of Harvard Medical School told the conference. An Israeli businessman set up the deal.
U.S. and European laws ban the sale of human organs and most tissue for transplant is taken fresh from the cadavers of the newly deceased. A smaller amount also comes from live donors, mostly people giving to save the life of a relative or friend.
But these supplies cannot expand to meet the demand, which is booming as medical advances make transplantation more reliable and illnesses cause more cases of kidney failure.
Some experts advocate the creation of a regulated market for human organs, a proposal several speakers rejected as unethical because it would turn body parts into commercial commodities and risky because it could persuade people not to donate anymore.
“Once a market model is introduced, there is no place for a donation model,” said Bert Vanderhaegen, ethicist at University Hospital in Ghent, Belgium. “If kidneys have a (monetary) value, all organs have to have a value. But nobody can sell his heart.”