In a recent episode of HDNet’s Dan Rather reports, the journalist criss-crossed the globe alongside an academic/activist and others trying to trace the international black market for human kidneys (PDF transcript).
Rather and his crew pieced together the path a kidney would have taken, all the way from a tiny, desperate Moldovan village (where furious villagers once attempted to lynch the woman who’d lured about 40 young men to Turkey with promises of work, then sent them home minus a kidney) to brokers like Levy-Izhak Rosenbaum, the New Yorker arrested for his alleged role in matching live donors to ailing patients.
While hard numbers are difficult to pin down in the ‘kidney pirate’ universe, Rather says black-market transplants like these are a growing problem, citing anecdotal evidence and a 2005 WHO report that found that a tenth of kidney transplants were arranged through the black market. Another reason for the black-market organ boom, Rather finds, is the emergence of new anti-rejection drugs that make it possible for almost anyone to give a kidney to anyone else.
Image from Wikimedia Commons
With more than 83,000 people waiting for kidneys in the United States alone, the potential benefit to patients is evident (though far from guaranteed, as Rather makes clear in the second half of the piece). The benefit to the donors is much more questionable.
While buyers spend up to $200,000 for a kidney, most of the money goes to a web of middlemen. Everyone from brokers to rogue surgeons, to bribed police and corrupt customs and border officials… all the average seller gets out of the deal, if he’s lucky, is about $3,000… and a tell-tale scar.”
For more on the price paid by the donors, Rather talked to well-known University of Pennsylvania bioethicist Arthur Caplan, Ph.D., who advocates criminal penalties for doctors who turn a blind eye to donors with dubious backgrounds as long as it saves their patient’s life.
If you say you are going to sell a kidney, coming from a poor village or a poor nation, nobody looks out for your health or your interest once that kidney’s out of your body. They toss you aside like an old piece of Kleenex. They don’t care. So you’re getting infections, you’re getting bleeds. You’ve got all kinds of problems going on, it’d be pretty easy to manage if you were getting followed post donation in an American or European hospital or in a developed country. You go back as a poor person who has sold their kidney, you’re in trouble.
The web of organized criminals matching donor to patient often centers in Istanbul, an international hub for illicit donations. The Turkish organ donation racket was pioneered by Yusuf Sonmez, a talented surgeon with questionable ethics and a knack for avoiding punishment. Somnez has recently been driven out of Turkey, but word on the street is that he’s still operating with impunity out of Azerbaijan.
There are signs in Istanbul that police are finally cracking down. … Turkish police rounded up more than 40 alleged kidney traffickers, but authorities here are still fighting an uphill battle against an insatiable global demand for kidneys. And it’s not just Turkish doctors. Rather even cites a recent incident in which a donor and patient hooked up through Craigslist, went to a Los Angeles hospital for the transplant, and apparently exchanged $25,000 in a restroom or hallway after the operation.
In the course of the story, Rather also visits Israel, another organ trafficking hotbed, and examines the toll the trade is taking up on patients as well as donors.
Josephine Marcotty of the Minneapolis Star Tribune recently wrote a series addressing the increasing demand for kidneys, a need spurred by an aging population, increases in diabetes, obesity and high-blood pressure. She found that it is a public health crisis that costs the nation $33.6 billion a year, and there is no end in sight.
Marcotty covered one woman’s search for a kidney, the ethics of paired donations and how the medical center decided who would get organs.
In this article for AHCJ members, she shares what she learned about kidney donation and how she reported the story.