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BMJ. 2007 November 17; 335(7628): 1013.
PMCID: PMC2078640

WHO reports growing commercial trade in transplant organs

Travelling abroad for organ transplants provided on a commercial basis—so called transplant tourism—may now account for at least one in 20 of all transplants, according to a report from the World Health Organization (Bulletin of the World Health Organization 2007 Nov 1 doi: 10.2471/BLT.06.039370).

Advertising of package deals that include a transplant—for example, a package costing £16 000 (€23 000; $34 000) for a kidney transplant in Pakistan—is flourishing, and the trade in organs is growing, the report found. “The results suggest that the international organ trade no longer represents sporadic instances in transplant medicine,” it says. “The total number of recipients who underwent commercial organ transplants overseas may be conservatively estimated at around 5% of all recipients in 2005.”

Reliable information on numbers and clinical outcomes is scarce, the report noted, but it reviewed information from media reports, journal articles, conference papers, reports from health ministries, national transplant registries, and other documents to assess the scale of the problem.

The most common way in which organs are traded across national borders is by potential recipients travelling abroad to undergo transplantation, but there are other strategies. “In some cases, live donors have reportedly been brought from Republic of Moldova to the United States, or from Nepal to India. In other cases, both recipients and donors from different countries move to a third country,” the review says.

The report found that organs from donors living in India are regularly transplanted to foreigners. The Voluntary Health Association of India estimates that about 2000 Indians sell a kidney every year. In Pakistan, as many as two thirds of the 2000 renal transplants performed in 2005 were estimated to have been for foreigners, according to the Sindhi Institute of Urology. In the Philippines, data from the National Kidney Transplant Institute show that 110 the 468 kidney transplants in 2003 were for patients from abroad.

Other countries where kidneys are reportedly sold include Bolivia, Brazil, Iraq, Israel, Peru, Turkey, and Colombia. In Columbia, the report says, 69 out of 873 organ transplants were performed for foreigners.

The review found that many of the studies on the outcomes of kidney transplants performed for non-local residents reported an increased frequency in medical complications, including the transmission of HIV and hepatitis B and C viruses. It notes, “The international organ trade links the incapacity of national healthcare systems to meet the needs of patients with the lack of appropriate regulatory frameworks or implementation elsewhere.

“It exploits these discrepancies and is based on global inequities. Accordingly, the growth and regularisation of the international organ trade should be regarded as a global public health issue,” the report concludes.”


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