• Woman on trial for stealing human kidney Daily Monitor | 17 April 2018
    [read the article]


    By Juliet Kigongo

    Woman on trial for stealing human kidney

    A woman has been committed to the High Court for trial on charges of aggravated human trafficking and luring her shop attendant into donating his kidney to her husband. Miria Rwigambwa, a businesswoman in Mbarara District is accused by Brian Arinaitwe of duping and facilitating him to India for removal of his body part. The accused appeared before Nakawa Grade One Magistrate, Noah Sajjabi who committed her to the High Court for trial...

  • CoE Statement on GKE

    STATEMENT ON THE GLOBAL KIDNEY EXCHANGE CONCEPT


    To download a copy of the statement, please click here.


    The concept of Global Kidney Exchange (GKE) has been recently proposed as a means to increase the number of donor-recipient pairs that can benefit from kidney exchange programmes in highincome countries (HIC). The Council of Europe Committee on Organ Transplantation (CD-P-TO) with the support of the Council of Europe Committee on Bioethics (DHBIO) has carefully studied the GKE proposal. Read their conclusions here.

  • Update extended April

    Participate in the DICG public consultation concerning the Declaration of Istanbul (2018 Edition)


    To view the draft DoI (2018 Edition) and provide your feedback via our survey, please click here.

    Deadline 20 April 2018


    To celebrate the 10th Anniversary of the Declaration of Istanbul (DoI), a working group of the Declaration of Istanbul Custodian Group (DICG) has prepared a draft update to the Declaration. The revisions made in this 2018 Edition are intended to ensure that the DoI remains a valuable source of ethical guidance for health professionals and policy makers during the next decade in the face of persisting and emerging challenges in organ trafficking and transplant tourism around the world. To achieve this goal, we need your help.

    Please share your time and expertise with us, and provide feedback on our draft documents here.

  • Council of Europe convention against organtrafficking enters into force Council of Europe Convention | 1 March 2018
    [read the article]


    By Council of Europe Convention against Trafficking in Human Organs

    Trafficking in human organs: Council of Europe convention enters into force

    The Council of Europe Convention against Trafficking in Human Organs entered into force today in the five first states that have so far ratified it: Albania, Czech Republic, Malta, the Republic of Moldova and Norway.

    The convention, the first international treaty aimed at preventing and combating trafficking in human organs, has been signed by another seventeen states...

  • Israeli organ-smuggling mastermind arrested in Cyprus [read the article]


    By AFP

    Israeli organ-smuggling ‘mastermind’ arrested in Cyprus

    PRISTINA, Kosovo — The Israeli ringleader of a global gang of organ traffickers has been arrested in Cyprus, Kosovan police said on Saturday.

    Moshe Harel is suspected of organizing dozens of illegal kidney transplants at the Medicus clinic in the capital Pristina in 2008, and is the man being held, according to local media...

  • Indias laws on organ transplants do little to protect rights of organ donors [read the article]

    [read the Vidhi Report]


    By Menaka Rao

    The legal framework needs to ensure that the donor gives informed consent as well as legal and medical aid for donors.

    In August 2016, Surat resident Brijkishore Jaiswal needed a kidney transplant and was all set to receive one from Shobha Thakur, a 42-year-old domestic worker from rural Gujarat. But in order to get the kidney, Jaiswal tried to pass Thakur off as his wife and said that she was donating the organ altruistically. Jaiswal was paying Thakur for her kidney and thus breaking the law, which bans commercial organ donation...

  • What are red marketsInternational Business Times | 09 December 2017
    [read the article]


    By Lara Rebello

    ‘What are red markets? World's major organ trafficking countries bank on poverty and desperation

    A recent investigative piece into the conditions of African migrants stuck in Libya raised the curtain on the underground slave trade rings in the country and triggered international calls for investigations into the matter. It also shed light on the organ market that has been burgeoning alongside — banking on the bodies of financially desperate migrants. The migrant crisis in Africa as well as other parts of the world has offered organ traffickers a steady flow of donors — willing or unwilling — to sever ties with their kidneys, livers and other body parts....

  • Woman on trial for stealing human kidney Daily Monitor | 17 April 2018
    [read the article]


    By Juliet Kigongo

    Woman on trial for stealing human kidney

    A woman has been committed to the High Court for trial on charges of aggravated human trafficking and luring her shop attendant into donating his kidney to her husband. Miria Rwigambwa, a businesswoman in Mbarara District is accused by Brian Arinaitwe of duping and facilitating him to India for removal of his body part. The accused appeared before Nakawa Grade One Magistrate, Noah Sajjabi who committed her to the High Court for trial...

  • CoE Statement on GKE

    STATEMENT ON THE GLOBAL KIDNEY EXCHANGE CONCEPT


    To download a copy of the statement, please click here.


    The concept of Global Kidney Exchange (GKE) has been recently proposed as a means to increase the number of donor-recipient pairs that can benefit from kidney exchange programmes in highincome countries (HIC). The Council of Europe Committee on Organ Transplantation (CD-P-TO) with the support of the Council of Europe Committee on Bioethics (DHBIO) has carefully studied the GKE proposal. Read their conclusions here.

  • Update extended April

    Participate in the DICG public consultation concerning the Declaration of Istanbul (2018 Edition)


    To view the draft DoI (2018 Edition) and provide your feedback via our survey, please click here.

    Deadline 20 April 2018


    To celebrate the 10th Anniversary of the Declaration of Istanbul (DoI), a working group of the Declaration of Istanbul Custodian Group (DICG) has prepared a draft update to the Declaration. The revisions made in this 2018 Edition are intended to ensure that the DoI remains a valuable source of ethical guidance for health professionals and policy makers during the next decade in the face of persisting and emerging challenges in organ trafficking and transplant tourism around the world. To achieve this goal, we need your help.

    Please share your time and expertise with us, and provide feedback on our draft documents here.

  • Council of Europe convention against organtrafficking enters into force Council of Europe Convention | 1 March 2018
    [read the article]


    By Council of Europe Convention against Trafficking in Human Organs

    Trafficking in human organs: Council of Europe convention enters into force

    The Council of Europe Convention against Trafficking in Human Organs entered into force today in the five first states that have so far ratified it: Albania, Czech Republic, Malta, the Republic of Moldova and Norway.

    The convention, the first international treaty aimed at preventing and combating trafficking in human organs, has been signed by another seventeen states...

  • Israeli organ-smuggling mastermind arrested in Cyprus [read the article]


    By AFP

    Israeli organ-smuggling ‘mastermind’ arrested in Cyprus

    PRISTINA, Kosovo — The Israeli ringleader of a global gang of organ traffickers has been arrested in Cyprus, Kosovan police said on Saturday.

    Moshe Harel is suspected of organizing dozens of illegal kidney transplants at the Medicus clinic in the capital Pristina in 2008, and is the man being held, according to local media...

  • Indias laws on organ transplants do little to protect rights of organ donors [read the article]

    [read the Vidhi Report]


    By Menaka Rao

    The legal framework needs to ensure that the donor gives informed consent as well as legal and medical aid for donors.

    In August 2016, Surat resident Brijkishore Jaiswal needed a kidney transplant and was all set to receive one from Shobha Thakur, a 42-year-old domestic worker from rural Gujarat. But in order to get the kidney, Jaiswal tried to pass Thakur off as his wife and said that she was donating the organ altruistically. Jaiswal was paying Thakur for her kidney and thus breaking the law, which bans commercial organ donation...

  • What are red marketsInternational Business Times | 09 December 2017
    [read the article]


    By Lara Rebello

    ‘What are red markets? World's major organ trafficking countries bank on poverty and desperation

    A recent investigative piece into the conditions of African migrants stuck in Libya raised the curtain on the underground slave trade rings in the country and triggered international calls for investigations into the matter. It also shed light on the organ market that has been burgeoning alongside — banking on the bodies of financially desperate migrants. The migrant crisis in Africa as well as other parts of the world has offered organ traffickers a steady flow of donors — willing or unwilling — to sever ties with their kidneys, livers and other body parts....

  • How Indians were trafficked for organs in EgyptThe Indian Times | 23 November 2017
    [read the article]


    By Sumitra Debroy

    ‘Donate your kidney or face jail in Cairo’

    Yaseer Ahmed Basha (29) father to a six-year-old son and a three-year-old daughter, is unaware that he too is now an accused in the international kidney racket for selling his left kidney to Malad resident Pankaj Rao. He maintained that he was threatened and tricked into giving his kidney after he went to Cairo in July with the promise of driving an Uber cab. "It was 99% deception, but 1% my greed for money." He now makes a living driving an autorickshaw to support his parents there and his family in Taloja...

  • Some U.S. Hospitals Dont Put Americans First for Liver TransplantsProPublica and Fox 8 WVUE New Orleans| 20 November 2017
    [read the article]


    By Charles Ornstein and Lee Zurik

    Some U.S. Hospitals Don’t Put Americans First for Liver Transplants

    At a time when there aren’t enough livers for ailing Americans, wealthy foreigners fly here for transplants.

    Dr. Gabriel M. Danovitch, Honoury member of the Declaration of Istanbul Custodian Group, talks about national self sufficiency in organ donation.

    Also see Fox 8 News video on this co-published story...

  • Delhi govt suspends Apollo Hospitals kidney transplantation licenceHindustan Times | 17 November 2017
    [read the article]


    By HT Correspondent

    Delhi govt suspends Apollo Hospital’s kidney transplantation licence

    The Delhi government has ordered the suspension of Indraprastha Apollo Hospitals’ licence for kidney transplants till January 5 after police busted a kidney racket involving secretarial staff of doctors working at the hospital last year.

    During the suspension period, the hospital cannot register new kidney transplant patients, but close to 40 patients who have been cleared by the committee for transplantation will continue with their treatment...

Incentives, kidney donation, and the myth of the Iranian waiting list

In a recent New York Times article, Tina Rosenberg argues that the United States should introduce financial incentives for living kidney donors. She writes, “In 2014, there were 17,106 kidney transplants in the United States, but more than twice that many people went on the waiting list.”

She believes that use of incentives could resolve this problem because the legal Iranian market for organs has “essentially eliminated” the waiting list for a kidney.

Such claims about the Iranian waiting list, which are commonly invoked in support of kidney markets in the United States and elsewhere, are simply false. People with end stage kidney failure living in the United States are more likely to receive a transplant than those living in Iran. Commentators debating the issue of incentives for donation have a responsibility to draw on the best available evidence in their arguments, and should not simply recycle and perpetuate myths about the success of the Iranian market.

What counts as proof that a waiting list has been eliminated?

The alleged success of the Iranian kidney market is regularly cited in public commentary and academic debate by advocates of financial incentives. References in scholarly publications can usually be traced back to a 2002 publication by Iranian nephrologist Ghods in which he declared that, “the renal transplant waiting list [in Iran] was eliminated by the end of 1999.”

What does it mean to “eliminate” a waiting list for transplantation? In many countries people in need of a kidney transplant may be unable to join a national waiting list for transplantation because

  • They cannot access healthcare services necessary for diagnosis of kidney failure, or required to prepare them for transplantation such as dialysis;
  • They cannot afford transplantation services or immunosuppression;
  • They do not meet eligibility criteria for the waiting list, where criteria such as age or comorbidities are designed to keep the list sufficiently short to match the supply of organs available for transplant;
  • There is no national waiting list for transplantation.

In a 2006 publication by Ghods and Savaj which is also cited as evidence that incentives have solved the problem of organ shortages in Iran, the authors again claim that “by 1999, the renal transplant waiting lists in the country was eliminated successfully”. In this paper, they offer an explanation which shows that the size of the waiting list in Iran is influenced by lower rates of diagnosis of end stage kidney disease:

In Iran, as in other developing countries, the prevalence of patients with ESRD is markedly lower compared with the prevalence of patients who are on renal replacement therapy in developed countries. A major cause of this is the many patients who are from villages and small towns and do not receive a diagnosis and are not referred for dialysis therapy. There also is no adopted restricting policy for accepting patients with ESRD for renal transplantation; however, the low prevalence of patients with ESRD results in fewer numbers of transplant candidates. This is the main reason that the renal transplant waiting list was eliminated quickly and successfully in Iran….”

Ghods, A. J., & Savaj, S. (2006). Iranian model of paid and regulated living-unrelated kidney donation. Clinical journal of the American Society of Nephrology, 1(6), 1136-1145. (p.1139)

The truth about the Iranian waiting list

Claims about the successful elimination of the Iranian waiting list in the early 2000s were questioned by commentators such as Griffin. However, incentive advocates have preferred to express ethical concerns about some elements of the Iranian model, arguing that better regulated incentive systems will address these, rather than to question the success of the model.

Commentators writing today ought to draw on more recent analysis of the Iranian market. A recent report by Iranian experts clearly shows that there is indeed a waiting list for kidney transplantation in Iran:

Rouchi, A. H., Ghaemi, F., & Aghighi, M. (2014). Outlook of Organ Transplantation in Iran. Iranian journal of kidney diseases, 8(3).

In this paper, the authors provide the following table summarising the disparity between the number of transplants and the number of patients waitlisted for transplantation in 2011:

Iran Waiting list

The authors note that, “the never-disappearing waiting list for kidney transplantation will be growing steadily”.

UNODC publishes toolkit for assessment of trafficking in persons for organ removal

Screen Shot 2015-06-28 at 5.11.07 pmThe United Nations Office on Drugs and Crime has published a toolkit for use in the assessment of trafficking in persons for organ removal.

"The toolkit aims to provide both a general overview of trafficking in persons for the purpose of organ removal and specific tools to assist concerned actors with assessing the phenomenon. The structure of the toolkit reflects this two-pronged approach in that its first part seeks to inform about the context in which trafficking in persons for organ removal can take place, the relevant legislative framework and international guidance, actors and modi operandi as well as good practice responses. The second part has very specific questionnaires that aim to allow for a better understanding of and a more systematic collection of data on the crime."

You can download the Assessment Toolkit here courtesy of UNODC.

Financial Incentives for Living Kidney Donors: Are They Necessary?

AJKD

 2015; Published online June 6


Dominique E. Martin and Sarah L. White

In the face of the perceived failure of altruistic organ donation programs to generate sufficient kidneys to meet demand, introducing financial incentives for living donors is sometimes argued as the only effective strategy by which lives currently lost while awaiting kidney transplantation might be saved. This argument from life-saving necessity is implicit in many incentive proposals, but rarely challenged by opponents. The core empirical claims on which it rests are thus rarely interrogated: that the gap between supply of and demand for donor kidneys is large and growing, the current system cannot meet demand, and financial incentives would increase the overall supply of kidneys and thus save lives. We consider these claims in the context of the United States. While we acknowledge the plausibility of claims that incentives, if sufficiently large, may successfully recruit greater numbers of living donors, we argue that strategies compatible with the existing altruistic system may also increase the supply of kidneys and save lives otherwise lost to kidney failure. We conclude that current appeals to the life-saving necessity argument have yet to establish sufficient grounds to justify trials of incentives.

To read the complete article, click here. (Subscription required.)

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