Written by Ashima Seth and Edited by Kevin Liu
Organ transplantation is a medical procedure often performed in the case of critical organ failure due to illness or injury. Explained simply, organ transplantation is the process of transferring organs from one body to another. Globally, over fifty percent of organ transplantations are of kidneys. The number of kidney transplants is closely followed by those of the liver and heart; together, they make up approximately ninety percent of the transplantations taking place annually across the world [1]. However, organ transplantation is not equally accessible to all who require it. Varying laws on the subject of organ transplants among countries, differences in treatment facilities, and the cost of healthcare all factor in to determine how accessible this medical procedure is – the most important determinant is organ availability.
Due to socio-cultural norms and legalities, as well the complexity and cost of determining the medical compatibility between donors and receivers, there is a severe shortage of organs available. This is particularly true in the case of deceased organ donations, where the process of donation directly contradicts the traditional funeral rites and customs that require the deceased body to remain intact. For the purposes of kidney and liver transplantation, live transplantations are also possible. However, this too is hindered by laws in several countries that prohibit the involvement of live organ donors [2]. Thus, the medical industry is facing increasing demand for organ donations and significantly less supply—leading to an increasing amount of people turning to international organ trade.
International organ trade is an illegal practice that can take place in multiple forms. Two of the most common forms are transplant tourism and organ trafficking. The term ‘transplant tourism’ refers to the practice of organ recipients travelling abroad for transplantations, whereas organ trafficking refers to the trafficking of humans for the purpose of harvesting their organs for profit. Historical trends have identified several countries as key organ exporters and importers for international organ trade, although several of the countries identified have since taken strict measures to curb organ trade, such as Iran with their living non-related donation program (LNRD) for kidney transplants.
International organ trade poses a risk to both the donor and the recipient, who are often in desperate positions. Current studies on the effects of international organ trade are severely lacking in data due to the difficulty of analyzing multiple variables and the lack of interest in the subject. However, qualitative analyses show lower post-transplantation survival rates in donors participating in this illegal network than considered acceptable by medical standards. International organ trade is notorious for encouraging the coercion of organ donors—especially in the case of kidney donation. Many organ donors come from very low-income backgrounds and participate unknowingly in this illegal network. They are also often underpaid for their organs and misinformed of the accompanying health risks [3].
As demand outpaces supply, the medical industry faces a key dilemma regarding the commercializing of the organ trade: to legalize or not to legalize? One of the primary case studies cited when considering the arguments on both sides is the Iranian government’s LNRD for kidney transplants, which was legalized in 1988. The benefits of this system include: regulation and funding by the Iranian government and other donors both living and unrelated to the recipient, appropriate compensation, and free health insurance. This model cuts out the middleman, reducing the likelihood of illegal organ trade. However, while this program’s post-transplantation survival rate among both donors and recipients has been within medically accepted standards, there have been several other issues touted against this program such as socioeconomic and ethnic discrimination [4].
References:
- Global Observatory on Donation and Transplantation (2017, September). Organ Donation and Transplantation Activities: 2015 Report. Retrieved from: http://www.transplant-observatory.org/download/organ-donation-transplantation-activities-2015-report-2/.
- Shimazono, Y. (2007). The state of the international organ trade: a provisional picture based on integration of available information. Bulletin of the World Health Organization, 85 (12): 901-980.
- Jafar, T.H. (2009). Organ Trafficking: Global Solutions for a Global Problem. American Journal of Kidney Diseases.
- Major, R.W.L. (2008). Paying kidney donors: time to follow Iran? McGill Journal of Medicine, 11(1): 67-69.