Medical practice

Illegal kidney trade 'booming'

The global trade in illegal kidneys is booming, according to The Guardian. In a front-page exposé, the newspaper has revealed how the demand for replacement organs is allegedly fuelling an illegal network of organ traffickers, making huge profits by buying kidneys from vulnerable individuals in developing countries and selling them on to wealthy people desperate for transplants.

The newspaper says that, according to World Health Organization projections, there are around 10,000 illegal transplants around the world each year. People in need of a kidney transplant are reported to have paid up to £128,000 in countries such as China, India and Pakistan, where organs are harvested from vulnerable people who may receive as little as £2,500. The Guardian article reports that an organ broker in China advertised his services using the slogan “donate a kidney, buy an iPad”, adding that the operation could be performed within 10 days.

The practice of selling kidneys and organs is illegal in many countries, and comes with great financial and medical risks. Performing a legitimate transplant is an incredibly complex procedure involving scrupulous medical tests and a range of measures to prevent infection and organ rejection. Purchasing a kidney from the black market offers no guarantees about the quality of the organ supplied or patient safety. Illegally purchasing a kidney should not be considered by those in need of a transplant, as it places them at great risk.

The news also highlights how desperately transplants are needed, and the chronic shortage of suitable donors. If you would like to know more about joining the organ donor register, see our information on organ donation.

What were the World Health Organization’s findings?

According to media reports, a worldwide network of doctors has collected evidence suggesting that there are an estimated 10,000 illegal black market operations involving trafficked and purchased human organs every year. Trading in organs, either from living or deceased individuals, is illegal in many countries, and goes against terms set out by the World Health Organization.

These are outlined in a WHO document called the Declaration of Istanbul, which sets out the circumstances and principles that should guide organ donation and transplantation. For example, it states that “the allocation of organs, cells and tissues should be guided by clinical criteria and ethical norms, not financial or other considerations”. It explicitly states that “cells, tissues and organs should only be donated freely, without any monetary payment or other reward of monetary value”.

Several national organisations, both in developed and developing countries, have endorsed the principles of the Declaration of Istanbul. However, the evidence the WHO presented to the media indicates that laws intended to halt trafficking are being ignored by traffickers keen to cash in on the rising international need for replacement kidneys.

According to evidence presented to The Guardian, 106,879 solid organs were transplanted in 2010 across 95 WHO member states, a total that met only 10% of the global need. It is not known how many of these transplants were performed legally and illegally, although experts have estimated that one in 10 of these transplants was performed illegally on the black market.

What is organ donation?

Organ donation involves extracting organs from living or recently deceased people and offering them to people in need of a transplant. Transplantable organs such as a kidney, heart or lung are surgically removed and transferred to the person in need of the organ through an operation. The most common organ donated by a living person is a kidney, as a healthy donor can continue to lead a normal life with only one functioning kidney. Organs such as a heart or lung can be transplanted after a person has died and there are standards and procedures that allow this to happen if the consent of the person donating the organ is given.

In the UK, more than 10,000 people are in need of some form of organ transplant that could save or improve their life. Of these, 1,000 will die while still waiting, as presently there are not enough organs available.

The number of people in need of a transplant is expected to rise steeply due to an ageing population, an increase in people with kidney failure and scientific advances that allow a wider range of people to benefit from a successful transplant. 

To read more about organ donation in the UK go to the NHS organ donation website.

Why are organs being traded illegally?

The long-running shortage of organs has prompted an increasing number of organs to be donated by living people, both legally and illegally.

According to experts, kidneys are estimated to make up 75% of the global illicit trade in organs. Although details of illegal kidney sales are understandably sketchy, the margins involved seem to be too hard for both traffickers and commercial organ donors to resist. Apparently, people in some developing countries are able to sell a kidney for the equivalent of several thousand dollars, far more than they might earn in a year. Equally, criminal gangs and doctors illegally aiding them would stand to share a six-figure sum charged to recipients. According to The Guardian, people are selling their kidneys for as little as $5,000 (around £3,000), which gangs are then selling on for up to $200,000 (£128,000).

The gap between the number of organs legally donated and the number of people waiting for a transplant is increasing. According to experts, a rise in diabetes and other diseases has increased demand for bought and sold organs, which has led to a lucrative industry of trafficking in some countries. Lack of laws prohibiting trafficking in some countries and poor law enforcement have been given as possible reasons contributing to the problem.

A WHO official has reported that there had been a decrease in “transplant tourism” back in 2006 and 2007. He added that “trade may well be increasing again” given the stakes are so high for potential recipients and the huge profits that such desperation can produce for criminal gangs.

How does organ donation work in the UK?

Trafficking of tissue and organs is illegal in the UK. Legal donation of organs can only take place following a person’s consent. There are two types of donation – donation following death and live donation.

For donation after death people are able to record their wishes about organ donation on a register. This allows their organs or tissue to be donated in the event of their death. Approximately 29% of people in the UK have joined the organ donation register.

Live donors are often close relatives, such as a parent, brother or sister, son or daughter. Related donors like these have an increased chance of being a compatible match. Live donors may also be individuals who are not related, such as a spouse, partner or close friend, of the recipient. Before becoming a live donor a person undergoes extensive health checks and checks to ensure the kidney is healthy.

There is a legal framework for organ and tissue donation in the UK. The Human Tissue Authority is the regulatory body that ensures there is no coercion, pressure or payment involved in the donation of organs, which is illegal in the UK. The authority must approve all donations from living donors and all donors are assessed by an independent assessor as a routine part of the evaluation process to ensure that all the legal requirements are met.

Read more about organ donation and find out how to become an organ donor in the UK at the NHS organ donation website.

NHS Attribution