How to get a kidney transplant overseas?
March 13, 2006 10:42 AM   Subscribe

Is there any legal means for a US resident to travel overseas to obtain a kidney?

A family member of mine has just been diagnosed with Acute Kidney Failue.

Our Entire Family was tested and it seems that no one is a match.

I found this on google [sponsored link]

Can anyone here tell me if there is any legal way my family member can get a kidney in the phillipeans, china, anywhere? want to live, will travel.
posted by anonymous to Law & Government (18 answers total)
Anon, I hope you will only consider options that are ethical as well as legal. For example, there is abundant evidence that the system in China is horrifyingly corrupt.
posted by alms at 11:01 AM on March 13, 2006

I cannot imagine that it is illegal. One may go to South Africa for cosmetic surgery. But +1 on the ethical question.
posted by jmgorman at 11:42 AM on March 13, 2006

posted by aberrant at 11:49 AM on March 13, 2006

In China, your American dollars can get you organs from political prisoners with death sentences.

In places like India and Pakistan, you can take advantage of the poorest of the poor.
posted by availablelight at 11:49 AM on March 13, 2006

Regarding the MeTa callout:

Just to be really explicit: yeah, it's legal. The links posted demonstrate that hundreds, perhaps thousands of Europeans and USians have already had it done--ever hear of a case prosecuted? Me neither. (Good luck getting follow-up care in the US, however, if anything goes wrong.)

The links also happen to address the fact that it is internationally condemned and widely regarded as repugnant. Good luck finding the info you need buried within any other kind of commentary. You decide to harvest organs from living/condemned brown people, you gotta know you're not going to get a lot of links to "feel-good" or even neutral info about whether/how this is done. It's not really in the same league as smoking pot or having an affair now, is it?
posted by availablelight at 11:59 AM on March 13, 2006

[removed the link to the made-up VICELAND story and follow-up comment. please try to keep answers on-topic or take them to the MeTa thread already in progress.]
posted by jessamyn (staff) at 12:09 PM on March 13, 2006

Trafficking in kidneys appears to be illegal in India and Pakistan.
posted by aberrant at 12:40 PM on March 13, 2006

(or, more correctly, trafficking appears to be illegal in India and might be illegal in Pakistan soon.)
posted by aberrant at 12:48 PM on March 13, 2006

Oh, but Turkey, Eastern Europe (think, "Moldova"), and of course China are still very open for business--at least if you've got yourself a broker and a six-figure fee! (New standard disclaimer: the following article also contain opinions and information that someone purchasing an organ may find hurtful or not very helpful for answering the question):

A few Americans do go abroad for paid transplants. A man named Jim Cohan, who lives in Los Angeles, helps organize such trips. Cohan insists that 'organ broker' is the wrong term for his profession. 'I call myself an international transplant coordinator,' he explains. He has been in the business a dozen years, he says, and has helped about 300 Americans.

'I got into transplant coordination when I discovered how long the waiting lists were and how many people were dying,' he says. According to the United Network for Organ Sharing, 2,583 Americans died last year waiting for a kidney. Worldwide, the number of annual deaths is estimated to be at least 50,000. 'There are plenty of spare organs to be had in other parts of the world,' Cohan says. 'There's no need for a single person to die waiting for a kidney.'

No person of at least some means, that is. Cohan's current price for a kidney, he says, is $125,000, all inclusive. 'First, send me $500, and I'll send you an application,' Cohan says. 'You and your doctor fill it out. Once you're accepted into the program, you have to send me a check for $10,000. The balance is due before you leave. Usually I can get an organ in less than a month. I send people to South America, to the Philippines, to China, Singapore and South Africa. Where you go depends on what's going on in the world and what's available.'
posted by availablelight at 1:04 PM on March 13, 2006

The Rich Pay To Get to Front of the Line for Organ Transplants
"There's no country where it's legally sanctioned, but it still happens," said Dr. Zaltzman, a Toronto transplant kidney specialist who is director of St. Michael's renal transplant program. "It happens like a black-market underground economy. We've had lots of patients who have gone. Some tell us and some don't tell us; they just come back with kidneys."
Big Risk in Overseas Transplants
"It was certainly a surprise that the outcomes were so bad," said Bruce Pussell of Prince of Wales Hospital.

"The technology is quite straightforward, and around the world it's about a 90 per cent survival rate after one year."

He said the five-year survival rate was only 60 per cent, compared with 82 per cent for local transplants.
posted by caddis at 1:11 PM on March 13, 2006

The closest answer as to where organ trafficking is legal is buried in availablelight's NY Times link:

The sale of human organs, whether from a living person or a cadaver, is against the law in virtually every country (Iran is perhaps the only exception)....

Although this talks about selling organs, not buying them, which was the poster's question, but it's probably safe to assume that if it's illegal to sell them, it's probably illegal (either directly or indirectly) to buy them. Whether the law is enforced is not germane to the question asked.
posted by aberrant at 1:23 PM on March 13, 2006

here is Jim Cohan's website.

From the site:
The cost for a Kidney or Pancreas is $140,000 U.S. The cost for a Heart, Lung, or Liver is $290,000 U.S. These costs include travel and all hospital fees, including the required organ, surgery, and medications needed for a successful organ transplant. The cost also includes travel and lodging for a friend, relative, or nurse, who accompanies the recipient, providing companionship and support during the transplant process. There are no additional costs.

posted by delmoi at 1:24 PM on March 13, 2006

As long as you don't bring the organ here in a cooler, you won't get prosecuted under US law for coming back with one newly-sewn into your body cavity. China is happy to do it for you, and thousands of Israelis have it done in places like Turkey, Eastern Europe, etc. as a "first resort".
posted by availablelight at 1:31 PM on March 13, 2006

And from aberrant's own link, there's still time to get 'er done legally in...that's right....Pakistan:

Thousands of kidneys are sold every year in several Pakistani hospitals due to the absence of a law barring the sale of human organs. [dateline: 1/28/06]

Used to be legal in Iraq as well (an interesting anecdote about the practice is at the end of the linked NYT article up thread), but probably not so much these days. Or at the very least, not a practical travel option, unless your relative also works for a defense contractor, etc.
posted by availablelight at 1:56 PM on March 13, 2006

I'll leave aside any moralizing, of which you've already received quite a dose. As you may have noticed, it is hard to get up-to-date information on the topic because of the almost universal disapproval of organ-marketing. However, at least in 2004, the evidence is strong that buying and selling of kidneys in Iran was legal and regulated. A Christian Science monitor story What is a kidney worth?"gives background on various countries' battles against buying and selling organs. The Monitor does list Iran as a country where it is legal.

Also, of possible interest, is a CNN transcript from an 2004 interview with the founder of Organ Watch which contains this on-topic Q&A:

"MANN: Should this be flatly illegal to your mind in every place where it's practiced?

SCHEPER-HUGHES: Well, it is illegal right now. There is only one country that I know of, and that's Iran, where it is legal to buy and sell, and it's under state control. I heard about Kuwait, though I don't know that. I have an Organs Watch assistant who has worked in Iran. But everywhere -- now some countries don't have laws. Some countries have laws that are a big ambiguous because they didn't anticipate the sale."

Of course, since 2004 the laws may have changed in Iran to outlaw organ markets, and it may be that their regulatory process prevents a visitor from the USA access to the organs, putting you back into a black-market situation (a market which does thrive by almost all accounts). In either case, caution is strongly urged in such undertakings, despite the gravity of your family's situation.

Unfortunately, while I can tell you that the National Organ Transplant Act of 1984 makes all marketing of organs inside the USA illegal, it's hard for a non-legal type such as myself to offer assurances on whether or not it is illegal to travel outside the USA to get the operation. There are references to black-market prosecutions in countries where the sale of organs is illegal, but obviously operating in a manner which is legal in the host country is a wholly different scenario.

Remember that just because a law hasn't been enforced, doesn't mean it won't be in the future. For example, US citizens use to travel and spend money in Cuba with relative impunity, but recently large fines have been assessed for the citizens of the "Land of the Free" who dared do so. Political winds change. I do imagine that a forthright admission of the purposes of travel could make things difficult at either end of the trip.
posted by mdevore at 2:04 PM on March 13, 2006

Whoops--it was technically illegal in Iraq back in 2001 (when the article was written) but the illegal trade there was popular and well-regarded enough that it was viewed as a model system (!):

The business, like a back-room poker game, seems continually on the move. The place to go is always changing -- first India, then China, then Russia, then Turkey. Lately, the kidney trade is said to be phasing out in Turkey and setting up shop in Moldova. Romania, too, seems to be an emerging player.

According to Friedlaender, though, one market trumps the rest. This market, he says, appears to offer kidney transplants performed by excellent surgeons, with careful screening of sellers, extraordinary postsurgical care and a success rate that evidently rivals even the finest U.S. hospitals. The program seems absent of false promises and persistent rip-offs. The price is a bargain. Some people have even idealized this program as a model of how a legalized system might one day function. It's located in Iraq.
posted by availablelight at 2:39 PM on March 13, 2006

Acute Kidney Failure. Also known as Acute Renal Failure, ARF, is often reversible. Have you inquired with your physician if this is the case? Perhaps you don't need a transplant?
posted by cahlers at 4:34 PM on March 13, 2006

Is it possible to get a paired donation? One of your family members could donate a kidney to a compatiable donor and a relative of the donor would donate to your family member.
posted by angrybeaver at 8:29 PM on March 13, 2006

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