The state of international organ tradeby Yosuke Shimazono

Bulletin of World Health Organizationhttp://www.who.int/bulletin/volumes/85/12/06-039370/en/

•Background

•Points of discussion

•Key messages

•Rating

•Issues for discussion

Background Points of Discussion Key Messages Rating Issues for Discussion

Background

• organ transplantation: the transfer of an organ from the body of one person (the donor) to another (the patient) with the intention of replacing the patient’s damaged or missing organ

• includes: heart, kidneys, eyes, liver, etc.

Background Points of Discussion Key Messages Rating Issues for Discussion

Background

• Organ donors may be living or dead

• Use of live donors for transplantation is practiced but purchase and sale of transplant organs from live donors are strictly prohibited

• 66,000 kidney transplants, 21,000 liver transplants and 6,000 heart transplants in 2005

• Rough estimate given limited and paucity of available information

Background Points of Discussion Key Messages Rating Issues for Discussion

Main points

1. Transplant tourism

2. Who gains? Who loses?

3. Consequences & effects

Background Points of Discussion Key Messages Rating Issues for Discussion

Transplant tourism

• Potential patient travels abroad to undergo organ transplantation

• Movement of patients is usually facilitated by intermediaries and healthcare providers

• Advent of internet has also played a crucial role in transplant tourism

• Some websites offer all-inclusive packages that range from US $70,000 to $160,000 in developed countries

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Transplant tourism

Background Points of Discussion Key Messages Rating Issues for Discussion

Transplant tourism

• Allegations of embassy officials and local doctors facilitating such organ transplants in Pakistan and the Philippines

• Major exporters: China, India, Pakistan, Philippines, Brazil, Bolivia

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Who gains? Who loses?

• May involve human trafficking for the purpose of organ trade

• Organ exporters vs Organ importers

• Statistics have shown organ donors are worse off financially and health-wise

• Ethical dilemma - in China, most of 12,000 kidneys and livers transplanted were from executed prisoners

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Who gains? Who loses?

• Number of patients have decreased because of Human Organ Transplantation Act of 1994

• But even with rules outlawing illegal organ trade, some doctors and medical institutions still persist

• Australia, Canada, Israel, Japan, Oman, Saudi Arabia and the USA are major organ-importing countries

• # of patients getting transplants overseas > # of patients locally

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Consequences and effects

• Newspaper articles have reported the death of patients who went abroad for overseas transplants

• Abuse, fraud, and coercion of paid kidney donors are also frequently reported

• Lower health standards: transmission of HIV, hepatitis B and C

• Fueled by desperate desire of patients to undergo organ transplant

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Economic and social effects of organ trade

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Key messages

• Organ trade is an economical, societal, and ethical problem

• Governments must step up and refine regulatory frameworks

• Urgent need to further medical and social scientific research

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Rating

8/10Background Points of Discussion Key Messages Rating Issues for

Discussion

Issues for discussion

• Given factors and circumstances indicated earlier, will organ trade ever be viable? Will you ever partake in it?

• What are some possible technological or readily-available alternatives to organ trading?

Background Points of Discussion Key Messages Rating Issues for Discussion